International Science Index


Patterns of Malignant and Benign Breast Lesions in Hail Region: A Retrospective Study at King Khalid Hospital


Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

[1] Seada LS, Al Rashid F, Negm A: A Four-Year Study of Thyroid Carcinoma in Hail Region: Increased Incidence. International Journal of Medical, Health, Biochemical, Bioengineering and Pharmaceutical Engineering, Vol 10 no.12, 2016.
[2] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108
[3] Anderson BO, Jakesz R. Breast cancer issues in developing countries: an overview of the Breast Health Global Initiative. World J Surg. 2008; 32(12):2578–85.
[4] Robinson IA, McKee G, Kissin MW. Typing and grading breast carcinoma on fi n e-needle aspiration: is this clinically useful information? Diagn Cytopathol. 1995; 13(3):260–5.
[5] Fisher ER, Redmond C, Fisher B. Histologic grading of breast cancer. Pathol Annu. 1980; 15(Pt 1): 239–51.
[6] Morgan D, Sibbering D, Galea M, Ellis I, Elston C, Blamey R. Selection for adjuvant therapy using the Nottinghams prognostic index. Breast. 1993; 2:187.
[7] Shyyan R, Masood S, Badwe RA, et al. Breast cancer in limited-resource countries: diagnosis and pathology. Breast J. 2006;12 Suppl 1:S27–37.
[8] Vargas HI, Masood S. Implementation of a minimally invasive breast biopsy program in countries with limited resources. Breast J. 2003;9 Suppl 2:S81–5.
[9] Feoli F, Paesmans M, Van Eeckhout P. Fine needle aspiration cytology of the breast: impact of experience on accuracy, using standardized cytologic criteria. Acta Cytol. 2008;52(2):145–51.
[10] Howell LP. Equivocal diagnoses in breast aspiration biopsy cytology: sources of uncertainty and the role of “atypical/indeterminate” terminology. Diagn Cytopathol. 1999;21(3):217–22.
[11] Hussain MT. Comparison of fi ne needle aspiration cytology with excision biopsy of breast lump. J Coll Physicians Surg Pak. 2005;15(4):211–4.
[12] Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19:403–10.
[13] Ruibal A, Arias JI, Del Río MC, Lapeña G, Schneider J, Tejerina A. Histological grade in breast cancer: association with clinical and biological features in a series of 229 patients. Int J Biol Markers. 2001;16:56–61.
[14] Al-Rikabi A and Husain S: Increasing prevalence of breast cancer among Saudi patients attending a tertiary referral hospital: a retrospective epidemiologic study.Croat Med J. 2012 Jun; 53(3): 239–243
[15] Amin TT, Al-Mulhim AR, Chopra R. Histopathological patterns of female breast lesions at secondary level care in Saudi Arabia. Asian Pac J Cancer Prev. 2009;10:1121–6.
[16] Najjar H, Easson A. Age at diagnosis of breast cancer in Arab nations. Int J Surg. 2010;8:448–52
[17] Akhtar SS, Nadrah HM, Al-Habdan MA, El-Gabbani SA, El-Farouk GM, Abdelgadir MH, et al. First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round. East Mediterr Health J. 2010;16:1025–31.
[18] Sait WA, Al-Amoudi SM, Tawtai DA, Abduljabbar HS. The knowledge of breast cancer among young Saudi females. Saudi Med J. 2010;31:1242–4.
[19] Westlake S, Cooper N. Cancer incidence and mortality trend in the United Kingdom and constituent countries 1993 to 2004. Health Stat Q. 2008;(38):33–46
[20] Ezzat N, Hafez N: The validity of immunocytochemical expression of cyclin D1 in fine needle aspiration cytology of breast carcinoma. Journal of the Egyptian National Cancer Institute. Volume 24, Issue 3, September 2012: 145–150.
[21] Elidrissi Errahhali M, Elidrissi Errahhali M, Ouarzane M, El Harroudi T, Afqir S, Bellaoui M. First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases. BMC Womens Health. 2017 Jan 9;17(1):3.
[22] B Lieske,1 D Ravichandran,1,* and D Wright1 : Role of fine-needle aspiration cytology and core biopsy in the preoperative diagnosis of screen-detected breast carcinoma . Br J Cancer. 2006 Jul 3; 95(1): 62–66.
[23] Blamey R, Hornmark-Stenstam B, Ball G, Blichert-Toft M, Cataliotti L, Fourquet A, et al. ONCOPOOL–a European database for 16,944 cases of breast cancer. Eur J Cancer. 2010;46(1):56–71.
[24] Moschetta M, Telegrafo M, Carluccio DA, Jablonska JP, Rella L, Serio G, et al. Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in the diagnosis of breast lesions. G Chir 2014;35:171-6.
[25] Tham TM, Iyengar KR, Taib NA, Yip CH. Fine needle aspiration biopsy, core needle biopsy or excision biopsy to diagnose breast cancer – Which is the ideal method? Asian Pac J Cancer Prev 2009;10:155-8.