Assessment of non lump changes among women who came with abnormal breast changes for cancer screening at FNAC Clinic at MAKCHS Pathology Department

Abstract

Background: Nipple discharge, nipple retraction and inversion the non-lump changes used. These changes could thus be helpful in early diagnosis of breast disease including breast cancer as they could be the only early indication of breast malignancy The breast is a highly sensitive organ especially in the females. Many physiological and pathological processes can lead to visible changes in morphology of the breast. Among these are the non-lump changes that may or may not occur with simultaneously with a lump. Aim and Objective: To assess non-lump changes and their association with age as seen among women who came with abnormal breast changes. Methodology: This was a Retrospective laboratory based study, conducted at MakCHS pathology department core lab located in Mulago (Kampala). A total of 38 slides were reviewed Slide samples are prepared and stained with both DQ and Papanicolaou. The slides were assessed for any cytological abnormalities and result analysis done using SPSS version 16. Results: ND was the commonest non-lump change, affecting women between 17years to 65 years. Twenty eight of the women (73.6%) had ND. 18 (47.3%) of all the patients presented with a clear ND, 6 (15.7%) with bloody ND, 4 (10.6%) with purulent ND and 1 (5.15%) presented with milky ND. 12 (28.6%) of the women presented with NR. Of these, 10 (8.33%) presented with both ND and NR. 8 (80%) of the patients with non-lump changes had a malignant process and 0 (0%) had a benign process and 2 (20%) had infections. Conclusion:Non-lump changes are not usually a sign of breast malignancy especially in younger women. Though not usually a sign of breast malignancy patients with non-lump changes should be closely monitored as these could be the only signs of a premalignant process. Recommendation:Nipple discharge cytology should be embraced as this could be one of the ways to monitor the presentation of malignancy. Triple assessment must also be given careful consideration as some of non-lump changes may not present with a significant palpable lump.