Breast Lesions During Pregnancy Diagnosed by Fine Needle Aspiration Cytology


ABSTRACT:BACKGROUND:The breast functions as a secretory gland during pregnancy due to the interaction of estrogen and progesterone, where the secretory unit is the lobule.OBJECTIVE:Is to highlight breast lesions during pregnancy and to show the importance of fine needle aspiration cytology in the diagnosis of these breast lesions.PATIENTS AND METHOD:This study was carried out within the Main Referral Training Center for Early Detection of Breast Tumors, Medical City Teaching Hospital, Baghdad (from the beginning of May 2006 till the end of August 2008). Fifty eight pregnant ladies presenting with different breast lesions were included, all were subjected to physical breast examination, ultrasonography of the breast and fine needle aspiration with 10 ml disposable syringe (20-22 gauge), spread on glass slides and fixed in 95% alcohol, stained with Pap stain and examined under light microscope.RESULT:Clinicopathological study of 58 pregnant ladies presented with breast lesions including the age (range between 17-42 years), chief complaint (pain 10(17.2%)cases, mass 30(51.8%) cases, discharge 3(5.2%) cases, painful mass 11(18.9%) cases, axillary mass 3(5.2%) cases and pain and discharge in 1(1.7%) case) , site of the lesion (left side 24(41.4%) cases, right side 27(46.5%) cases and bilateral in 7(12.1%) cases.), the time of presentation during pregnancy (first trimester 19(32.8%) cases, second trimester 26(44.8%) and third trimester 13(22.4%) cases.) Our results show that breast lesions presented during pregnancy were benign in 54 (93.1%) cases, and malignant in 4 (6.9%) cases (all were breast carcinoma), the benign lesions include: fibroadenoma 15(25.9%) cases, inflammatory lesions 13(22.4%) cases, galactocele 8(13.8%) cases, fibrocystic changes 6(10.3%) cases, pregnancy related changes 5(8.6%) cases, lactating adenoma 3(5.2%) cases, 2(3.5%) cases lipoma, and papilloma one (1.7%) case , and one case was diagnosed as accessory axillary breast tissue.CONCLUSION:The majority of breast lesions during pregnancy are benign; however, a small percentage of these lesions prove to be malignant. Aspiration cytology has a place in the work up of abnormal areas found in pregnant breasts but an experienced cytologist with knowledge of the clinical setting is required.