Breast diseases: Comparing the initial clinical diagnosis with the definitive histological report

Abstract

Background: Breast lump is a common clinical presentation of breast lesions. The physical characteristics associated with breast lumps are very vital in making a clinical diagnosis of breast disease.
Objective: To evaluate the accuracy of the initial clinical diagnosis (as obtained from the physical characteristics of the breast lump) with the definitive histopathological report of the various breast lesions.
Methodology: A one-year prospective study of all consecutive patients with palpable breast lumps presenting at the general surgery out-patient clinic of a tertiary health institution. Patients were evaluated clinically and then followed up until the histology reports were obtained following open surgical biopsy. The data were entered into a database and statistical analyses carried out using the Statistical Package for Social Sciences (SPSS) version 17.0.
Results: Of the 110 patients evaluated, 47.3% had malignant breast lesions while 52.7% others had benign lumps. Fifty-four individuals had masses greater than 5cm in their widest diameter, 13 of which were benign and 41 malignant. Thirty-five subjects had axillary lymphadenopathy, 30 were malignant while five were histopathologically benign. Forty-seven tumours were hard: 3(6.4%) benign and 44(93.6%) malignant. Of the 37 patients with attached growths, 3(8.1%) had benign disease while 34(91.9%) were malignant. Out of 52 cases with malignancy, 23(44.2%) had no cutaneous involvement while 29(55.8%) manifested at least one skin change. Only 4(6.9%) people out of 58 with benign diagnosis had skin changes.
Conclusion: The physical characteristics of breast masses still accurately reflect the histopathological diagnosis.