Breast lesions are a heterogeneous group of disorders ranging from inflammatory lesions to invasive cancers. Breast masses are the most common complaint with which females patients present to the hospital. The majority of these lesions are either benign or non-neoplastic [1]. Fine needle aspiration cytology (FNAC) is one of the most common tests for palpable lesions. It is one of the preliminary tests done on palpable breast masses. FNAC is also a part of the triple assessment test for breast masses [2].

It is minimally invasive, cost-effective and diagnostic accuracy is good [3]. Rapid turnaround times help in same day diagnosis of breast lesions and early management. The quick identification of benign breast diseases decreases the apprehension of patients [4]. This study was conducted to determine various forms of benign breast lesion presented to our hospital.

Benign breast disease (BBD) has a high prevalence and a noticeable impact on women's quality of life and, for certain histological types, increases breast cancer risk [5]. It has been estimated that one out of every two women may develop some form of fibrocystic breast disease during her lifetime and that one out of every five women may develop fibroadenoma. Although BBD has been extensively studied, the etiology of this disease is still poorly understood.

It appears that endocrine factors are associated with BBD. However, the associations found are weak and inconsistent [5]. Obesity has been identified as one of the only consistent risk factors for BBD.Conflicting results have been found for most risk factors, including exogenous hormone use, smoking, alcohol and caffeine intake. No studies have examined whether radiological tissue density is a risk factor for BBD [6].

Setting: Department of Pathology, Gadag Institute of Medical Sciences, Gadag

Duration of Study: 5 years 6 months from June 2015 to December 2020

Type of Study: Cross-sectional retrospective observational study

Sampling methods: Universal sampling

Table 2: Comparison of Cytomorphological findings with other studies

Figures

Figure 1 : Fibroadenoma: Smear studied show benign ductal epithelial cells arranged in sheet, arranged in staghorn pattern along with myoepithelial cells and bare nuclei in the background. (H& E Stain: 10 X)

Figure 2 : Granulomatous Mastitis: Smear studied shows epithelioid granuloma admixed with multinucleated giant cells and lymphocytes. (2A: Granuloma H&E Stain 10 X; 2B: Multinucleate giant cells H&E Stain 10X)

Fibroadenoma was the most common diagnosis in our study, with 244 (56.8%) cases. Our finding was in agreement with most of the available literature on benign breast lumps, where the frequency of fibroadenoma ranged from 46.6%-55.6% [10-13]. Sangma et al. had reported similar results with 52.74% cases and Albasri et al. 43.3% cases, as shown in Table 2 [9,14]. The slightly higher frequency in our study had no particular contributing factor.

The peak incidence of fi­broadenoma ranged from the 2^nd to the 3^rddecade of life, which was consistent with the findings of other studies. FNAC was the quickest and the most reliable method which helped in making the diagnosis of breast lumps.

The fibrocystic change was seen in 48(11.3%) cases which were similar tothe study by Sangma et al.[9] with 19.7% of cases, and Albasari et al. [14] had 23.4% cases. The fibrocystic changes were the following common condition in our study, and a majority of the patients belonged to the 3^rd and 4^thdecades. The incidence varies geographically. Many authors like Adesunkanmi AR and Agbakwuru EA and Ihekwaba FN found that the incidence of the fibrocystic changes ranged from 29.5-42.2% for benign breast lumps [10-11]. We had a slightly smaller figure, with 11.3 %.The mean age at presentation was 31 years. This was almost similar to the observation which was made by Navneet Kaur et al.[15].Our study has the limitation of having a small sample size, and being a retrospective study, there will be deficiencies of incomplete data collection. However, it provides baseline data of the patient population presenting to our hospital.

FNAC is a simple, minimally invasive test that can help in giving rapid diagnosis and triaging patients with non-neoplastic, benign lesions for appropriate management. The purpose of a thorough understanding of benign breast disease is threefold: 1) to alleviate, when possible, symptoms attributable to benign breast disease, 2) to identify patients with an increased risk of breast cancer 3) to distinguish benign from malignant breast disease, and so that increased surveillance or preventive therapy can be initiated. FNAC can achieve this in association with mammography and biopsy. It is advisable for early diagnosis of benign breast diseases to decrease the mortality and morbidity associated with these lesions where treatment can be initiated at the earliest.