A prospective comparative study of preoperative and postoperative clinicopathological correlation of fibroadenoma of breast: A study protocol

Introduction

Fibroadenoma is a common cause of benign breast lumps in young women between the ages of 15 and 35.¹ In Fibroadenoma of the breast, clinical evaluation and fine needle aspiration biopsy is the primary component in formulating a diagnosis and predicting benign or malignant breast lump. Cancer in newly found Fibroadenoma is incredibly uncommon.² Fibroadenomas frequently appear as firm, easily movable masses that wax and wane with the menstrual cycle and may become larger over several months. Fibroadenoma causes no pain, when touched, moves easily within the breast tissue. All patients with breast lumps in the premenopausal period should be suspected of breast fibroadenoma. Fibroadenomas typically have a size of 2 to 3 cm, but they can grow to > 10 cm and result in asymmetry or hypertrophy of the breasts. The eventual treatment plan depends upon the diagnosis of a breast lump. The applicable methods for diagnosing breast lumps are core needle biopsy (C.N.B.) and fine-needle aspiration cytology (F.N.A.C.). Recent years have seen the development of F.N.A.C. and C.N.B. as highly effective diagnostic techniques for examining palpable breast masses.³ Either a core biopsy or a tiny needle aspiration is used for tissue sampling. The simplicity of the procedure, low cost, and, most importantly, low risk of complications are some of the benefits of F.N.A.C. It is minimally invasive, doesn't call for anesthesia, and is generally patient-friendly.^4,5 Additionally, two to four days following aspiration, the results are accessible. The gold standard diagnostic test for Fibroadenoma of the breast is considered to be a surgical biopsy pathological examination. Since it is normal for fibroadenomas to diminish naturally, the majority are just watched. Surgery is advised when the Fibroadenoma becomes larger or the symptoms worsen. Recent research has shown that the prevalence of breast disease is rising. After the age of 40, it is seldom ever observed in women. Fibroadenomas are well-encapsulated lumps that can easily separate from the breast tissue around them. Additionally, many women can avoid excision because a sizeable number of fibroadenomas over a 5-year period remain static or shrink in size.⁶ Sixty-five percent of patients with fibroadenomas that contain cancer have lobular in situ malignant neoplasms.⁷

Protocol

Methods

Discussion

It is a prospective comparative study comparing the clinicopathological connection of breast fibroadenoma before and after surgery. Histopathological findings were correlated with F.N.A.C. for the diagnosis of the disease is essential to know how efficient F.N.A.C. is in diagnosing Fibroadenoma of the breast preoperatively.

Early detection and treatment are crucial to lowering mortality rates in breast cancer cases, and cancer in newly detected Fibroadenoma is exceedingly rare.⁸ The main usage of imaging techniques is for screening. In the majority of patients, treatment depends upon F.N.A.C. (fine needle aspiration cytology) and C.N.B. (core needle biopsy) reports, which claim to be extremely accurate and closely resemble histological results.³

F.N.A.C. is less invasive than core needle biopsies and is more accurate, affordable, and simple to do.⁹ The common cause of a false negative cytological diagnosis is known to be the absence of a lesion on sampling during aspiration.¹⁰ False-negative and ambiguous diagnoses are notably common in F.N.A.C. of invasive lobular cancer. This is due to the fact that a paucicellular smear with mild atypia and infrequent single intact epithelial cells is more likely to result from classic invasive lobular cancer.¹¹

Feichter et al. found that out of 1472 FNAC of the breast. Cytological diagnosis was benign in 1003 cases(68.1%), 239(16.2%) aspirates were inadequate, false negative cases were (9%), and false positive cases were (0.5%).¹²

Kuijper et al. Conducted a study of histopathological features of Fibroadenoma of the breast in 396 cases. In 32.3% of cases, hyperplasia was discovered. Carcinoma in situ was found in 8 cases (2.0%). In 40.4% of cases, complex histologic characteristics were present, primarily in somewhat older patients. In 8.8% of cases, the surrounding tissue had hyperplasia, which was typically present in older patients.¹²