Spectrum of Breast Diseases: Histopathological and Immunohistochemical Study from North India

Breast disorders commonly present as masses, which are mostly benign. However, breast cancer is the most common form of cancer and second leading cause of death among women. The study aimed at analyzing the spectrum of breast diseases especially breast cancers and assess the estrogen and progesterone receptor (ER/PR) and Her2/neu status of breast cancers on immunohistochemistry (IHC).

This was a descriptive study of 2 years (Jan 2014 - Dec 2015). All specimens of primary breast diseases received during this period at the Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, UP, India, were analyzed.

A total of 148 breast specimens from 10 males and 133 females, (age range, 15 - 75 years; mean age, 36 years) were selected. Majority of patients presented in 4th (29.7%) and 3rd (27.7%) decades with breast lumps (97.3%), affecting mostly right breast (52%). Benign diseases (60.1%) were the commonest followed by malignant (28.4%) and inflammatory lesions (11.5%). Fibroadenoma (52.6%) and fibrocystic change (21.8%) were the commonest benign diseases and granulomatous mastitis (23.5%), the commonest inflammatory lesion. Malignancy contributed 30.6% of female breast lesions (age range, 25-75 years and mean age, 48.2 years) with 97.6% of cases being infiltrating ductal carcinomas. ER expression was seen in 58%, PR in 54.8% and Her2/neu positivity in 45.2% cases. In males, gynecomastia was the most common breast lesion (90.9%).

Breast diseases affected mostly young people with fibroadenoma and infiltrating ductal carcinoma being the commonest diseases. Malignant breast diseases affected females only. ER/PR hormone receptor expressions are lower compared to western countries.