Histopathologic Spectrum Of Benign Breast And Its Dermatological Lesions In A Tertiary Health Institution, Southeast Nigeria. (A 10-Year Review)
Ezejiofor I. F
Department of Anatomic Pathology & Forensic Medicine. Nnamdi Azikiwe University Awka, Nigeria.
Olaofe O. O
Dermatology Department, Nnamdi Azikiwe University Awka, Nigeria
Ezejiofor O. I
Department of Anatomic Pathology & Forensic Medicine. Nnamdi Azikiwe University Awka, Nigeria
Osonwa C. N
Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife, Osun State, Nigeria.
Ukoha S. S
Department of Histopathology. Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Nigeria
Ilegbedion, I.G
Department of Medical Laboratory Science Faculty of Basic Medical Sciences , College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
Ezeofor, P.C
Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi Nigeria.
Keywords: Southeast Nigeria, fibroadenoma, fibrocystic changes, fibroepithelial polyp, Atypical ductal hyperplasia, Virginal breast hypertrophy
Abstract
Background: Spectrum of all benign breast lesions. Aims and objectives: To study the histologic patterns of all benign breast lesions as well as benign skin diseases of the breast, with respect to age, and sex. We also aimed at highlighting the premalignant lesions and to showcase the importance of histology in evaluating and preventing misdiagnoses encountered in breast lesions. Methodology: Is a 10-year retrospective analysis of all histologically diagnosed benign breast diseases (BBDs). Request forms were reviewed for clinical bio-data, and diagnosis. Hematoxylin and eosin stained-slides of breast biopsies carried out at Histopathology department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, were archived and studied. Results: A total of 1,568 breast lesions were received, 881 cases (56.2%) were benign lesions, while 687cases (43.8%) were malignant giving a ratio of 1.3:1. Benign breast lesions accounted for 10.9% (881/8090) of all surgical biopsy specimens Eight hundred and fifty-three (n=853; 96.8%) were females and 28 were males (3.2%) giving a female to male ratio of 30:1. The age, ranged, from 1-90 years, with a mean age of 29.7 SD± 12.9 years, and the peak age incidence was 21-30 years constituting 36.3% (320/881) cases of BBDs. The mean age for patients with fibroadenoma was 23.1 SD ± 7.9 years and 35.0 SD ± 11.7 years for fibrocystic change of the breast. Right breast was involved in 409 patients (46.4%), while left involved 363 (41.2%), 89 (10.1%) bilateral and 20 cases (2.3%) were unspecified. The histopathologic analysis showed nine cases (n=9; 1.13%) of benign neoplastic and inflammatory skin diseases of the breast with fibroepithelial polyp being the commonest with 33.3% (n=3/9) followed by psoriasis and epidermal inclusion cyst with 2 cases (22.2%) each. Fibroadenoma was the most common BBDs accounting for 40.7% cases (n=357/881) followed by fibrocystic changes 28.4% (n=249/881) then fibrodenomatous hyperplasia 7.3% (n=64/881) with least representative lesion being developmental breast lesion (Virginal breast hypertrophy) 0.1% (1/881). Only 0.6% cases (n=5/881) of atypical ducal hyperplasia and one case (n=1; 0.1%) of flat epithelial atypia were seen. However, 9 cases of fibroadenoma and 4 cases of fibrocystic changes and one case of gynaecomastia showed usual ductal hyperplasia.
Conclusion: Fibroadenoma constituted the most common histopathological patterns of BBDs while Fibroepithelial polyp was the commonest dermatologic breast skin lesion in our environment. However, more cases of usual ductal hyperplasia with few cases of atypical ductal hyperplasia were seen.