Histopathological Spectrum of Benign and Borderline Breast Lesions: A Cross-sectional Study from Vindhya Region, Madhya Pradesh, India

Introduction: Breast pathology encompasses a wide spectrum, ranging from benign conditions to invasive cancers, posing significant diagnostic challenges. Most breast lesions are usually divided into benign and malignant disorders, and their prognosis can often be reasonably predicted. However, certain tumours exhibit borderline characteristics and occupy a grey area between benign and malignant, making it difficult to forecast their course with any degree of accuracy. Aim: To assess the histopathological spectrum of benign and borderline breast lesions. Materials and Methods: This cross-sectional study, conducted over a period of five years (January 2019 to December 2023) at Shyam Shah Medical College, Rewa, Madhya Pradesh, India analysed 831 cases of breast lesions to determine their clinicopathological features, such as laterality of the breast and gross features. Grossing of the specimens was performed, and details were noted. Tissue pieces were processed, and sections were stained using conventional Haematoxylin and Eosin (H&E) staining. Results: Out of 831 breast lesions, 640 (77.0%) cases were benign, 15 (1.8%) were borderline, and 176 (21.2%) were malignant. Fibroadenoma was the most frequent lesion in females with 419 cases (50.4%), with a mean age of 21.4 years. In males, gynaecomastia was the most common finding in 21 (2.5%), with a mean age of 17 years. The second most common lesion overall was fibrocystic disease 148 (17.8%), with a mean age of 33.5 years. Other benign lesions included inflammatory breast diseases 21 (2.5%), lactational adenoma 2 (0.24%), sclerosing adenosis 7 (0.84%), microglandular adenosis 8 (0.96%), tubular adenoma 7 (0.84%), benign phyllodes 4 (0.48%), and lipoma and hamartoma 3 (0.36% combined). Borderline lesions included atypical ductal hyperplasia 9 (1.08%), ductal carcinoma in-situ 3 (0.36%), and borderline phyllodes tumours 2 (0.12%). Conclusion: In the study population, the range of benign breast diseases appears consistent with findings from other studies, with fibroadenoma emerging as the predominant benign lesion, followed by fibrocystic changes. While premalignant lesions were less prevalent in present study, a thorough evaluation of all cases of breast lesions is recommended to rule out the potential for breast cancer.