IMPORTANCE OF PHYSICAL EXAMINATION IN EARLY DETECTION OF LUMP IN BREAST IN WOMEN OF DIFFERENT AGE GROUPS

Authors

  • Hafsa Abbas
  • Saira Imran
  • Noorul -ain-Hafeez Waris
  • Andleeb Khanam
  • Rukshshan Khurshid

Abstract

Background: The spectrum of breast lesions in adolescents varies markedly from that for adults,with the former lesions being overwhelmingly benign. Fine needle biopsy can be used to distinguishbenign and malignant tumour. Study Design: This study examined the characteristics and outcomeof women with different age groups in whom physical examination was their sole method of lump inbreast detection. Patients and Methods: A total of 200 patients were included in the study. Thesewere divided into 3 groups. Group A was consisting of 75 girls with age of pubescent. Group Bincluded 69 suspected breast cancer women with age range 26–38 years. Fifty-six suspected breastcancer women with age range 41–60 year were included as group C. Study was carried out inpatients admitted in the Department/Out-door of Surgery, Sir Ganga Ram Hospital, Lahore, Pakistan.Study period was 6 months. All women received a physical examination by a breast surgeon.Proforma including demographic and clinical characteristics were filled. The diagnosis for patients inthis study was achieved by core needle biopsy using a 14-gauge cutting needle. Results: It wasobserved that early age at menarche (<15 year) plays an important role in developing both type oftumour, i.e., benign or malignant. Body Mass Index (BMI) with a range of 19–25 may be a riskfactor in developing both type of tumours especially in pubescent and reproductive age, whileBMI>25 may be a risk factor in peri/post menopausal women. Active life style is more importantwith increasing age as it decreases the risk of developing tumour state. Family history was morecommon in women with peri/post menopausal status as compared to other age groups. Clinicalcharacteristics showed that lump size <2.5 cm was more common in both pubescent andreproductive age. While lump size with a range of 2.5–5.0 cm, was observed in all groups of patients.Fibroadenoma is observed in almost all women with pubesenct age while both benign and malignanttumour observed in women with reproductive age. Malignant tumour was observed mostly inwomen with peri/post menopausal status. Conclusion: Study concluded that early detection orclinical examination with FNA cut out the patients from harassment of malignancy andcomplications especially in the pubescent age. It is also found that Physical examination remain theuseful indicators of prognosis in diagnosing cancer. Further research is needed to fully understandthe reasons for variations in breast disease outcomes i.e. malignant or benign.Keywords: Breast cancer, Fibroadenoma, Physical examination

References

Hellmann SS, Thygesen LC, Tolstrup JS, Grønbæk M. Modifiable

risk factors and survival in women diagnosed with primary breast

cancer: results from a prospective cohort study. Eur J Cancer Prev

May 24. [Epub ahead of print]

Press DJ, Pharoah P. Risk Factors for Breast Cancer: A Reanalysis

of Two Case-control Studies From 1926 and 1931 Epidemiology

May 21. [Epub ahead of print]

Love SM, Gelman RS, Silen W. Fibrocystic ‘disease’ of the breast–

a nondisease? N Engl J Med 1982;307:1010–4.

Kuijper A, Mommers EC, van der Wall E, van Diest PJ.

Histopathology of fibroadenoma of the breast. Am J Clin Pathol

;115:736–42.

Greenberg R, Skornick Y, Kaplan O. Management of breast

fibroadenomas. J Gen Intern Med 1998;13:640–5.

Houssami N, Cheung MN, Dixon JM. Fibroadenoma of the breast.

Med J 2001;174:185–8.

Santen 1RJ, Mansel R. Benign breast disorders. N Engl J Med

;353:275–85.

Torres-Mejía G, Angeles-Llerenas A [Reproductive factors and

breast cancer: principal findings in Latin America and the world]

Salud Publica Mex 2009;51 (Suppl 2):s165–71.

Carter BA, Page DL, Schuyler P, Parl FF, Simpson JF, Jensen

RA, et al. No elevation in long-term breast carcinoma risk for

women with fibroadenomas that contain atypical hyperplasia.

Cancer 2001;92:30–6.

Buzanowski-Konakry K, Harrison EG Jr, Payne WS. Lobular

carcinoma arising in fibroadenoma of the breast. Cancer

;35:450–6.

Deschenes L, Jacob S, Fabia J, Christen A. Beware of breast

fibroadenomas in middle-aged women. Can J Surg1985;28:372–4.

Diaz NM, Palmer JO, McDivitt RW. Carcinoma arising within

fibroadenomas of the breast: a clinicopathologic study of 105

patients. Am J Clin Pathol 1991;95:614–22.

Dupont WD, Page DL. Risk factors for breast cancer in women

with proliferative breast disease. N Engl J Med1985;312:146–51.

Dupont WD, Page DL, Parl FF, Vnencak-Jones CL, Plummer

WD Jr, Rados MS, et al. Long-term risk of breast cancer in

women with fibroadenoma. N Engl J Med 1994;331:10–5.

American Cancer Society. Non-Cancerous Breast Conditions.

What Sizes Are Fibroadenomas? J Natl Cancer Inst

;96(12):906–20.

Diratzouian H, Freedman GM, Hanlon AL, Eisenberg DF,

Anderson PR. Importance of physical examination in the absence

of a mammographic abnormality for the detection of early-stage

breast cancer. Clin Breast Cancer 2005;6(4):330–3.

Goehring C, Morabia A. Epidemiology of benign breast disease,

with special attention to histologic types. Epidemiol Rev

;19:310–27.

Hartmann LC, Sellers TA, Frost MH, Lingle WL, Degnim AC,

Ghosh K, et al. Benign breast disease and the risk of breast cancer.

N Engl J Med 2005;353:229–37.

Phipps AI, Ichikawa L, Bowles EJ, Carney PA, Kerlikowske K,

Miglioretti DL, et al. Defining menopausal status in epidemiologic

studies: A comparison of multiple approaches and their effects on

breast cancer rates. Maturitas. 2010 May 20. [Epub ahead of print]

Mah PM, Webster J. Hyperprolactinemia: etiology, diagnosis, and

management. Semin Reprod Med 2002;20:365–74.

Sklair-Levy M, Sella T, Alweiss T, Craciun I, Libson E, Mally B.

Incidence and management of complex fibroadenomas. Am J

Roentgenol 2008;190(1):214–8.

Chung EM, Cube R, Hall GJ, González C, Stocker JT, Glassman

LM. From the archives of the AFIP: breast masses in children and

adolescents: radiologic-pathologic correlation. Radiographics

;29(3):907–31.

Okobia MN, Bunker CH. Epidemiological risk factors for breast

cancer--a review. Niger J Clin Pract 2005;8(1):35–42.

Valagussa P, Zambetti M, Bignami P, de Lena M, Varini M,

Zucali R, et al. T3b-T4 breast cancer: factors affecting results in

combined modality treatments. Clin Exp Metastasis 1983;1:191–

Azim HA, Eldweny HI, Abdel Maksoud IG, Elbasmy AA. Review

article optimizing the use of her-2/neu targeting agents in breast

cancer : a developing nation perspective. J Egypt Natl Canc Inst

;19(4):225–30.

Nathanson SD, Kwon D, Kapke A, Alford SH, Chitale D. The

Role of Lymph Node Metastasis in the Systemic Dissemination of

Breast Cancer. Ann Surg Oncol 2009 Aug 6. [Epub ahead of print]

Guray M, Sahin AA. Benign Breast Diseases: Classification,

Diagnosis, and Management. The Oncologist 2006;11(5):435–40.

Downloads

Published

2010-06-01