FREQUENCY OF BREAST MALIGNANCY IN WOMEN PRESENTING WITH BREAST LUMPS IN SANDEMAN PROVINCIAL HOSPITAL, QUETTA

Abstract

Background: Breast lumps are common clinical presentations and may represent benign or malignant lesions. Histopathological confirmation is essential for definitive diagnosis. Hospital-based data on breast malignancy among women presenting with palpable breast lumps remain limited in Balochistan. Objective: To determine the frequency of histopathologically confirmed breast malignancy among women presenting with breast lumps at Sandeman Provincial Hospital, Quetta, and to assess its association with age, family history, and selected clinical characteristics. Methods: This hospital-based cross-sectional study was conducted in the Department of Surgery, Sandeman Provincial Hospital, Quetta, from 01 January 2025 to 30 June 2025. A total of 100 women aged ≥18 years presenting with palpable breast lumps were enrolled using consecutive non-probability sampling. Women with previous or recurrent breast cancer or inadequate diagnostic evaluation were excluded. Demographic and clinical data were collected using a structured proforma. Clinical examination, ultrasonography and/or mammography were performed as clinically indicated, followed by tissue diagnosis. Histopathological examination was considered the reference standard for classification of breast lesions. Data were analyzed using SPSS version 27.0. Categorical variables were assessed using Pearson's chi-square or Fisher's exact test, while age was compared using an independent-samples t-test. A two-sided p-value <0.05 was considered statistically significant. Results: The mean age of participants was 43.2 ± 12.1 years. Histopathological examination confirmed breast malignancy in 32 (32.0%) women, while 68 (68.0%) had benign lesions. Invasive ductal carcinoma was the predominant malignant histological type, occurring in 27 (84.4%) malignant cases, followed by invasive lobular carcinoma in 3 (9.4%) cases and other malignant lesions in 2 (6.2%) cases. Women with malignant lesions were significantly older than those with benign lesions (51.6 ± 9.7 vs. 39.2 ± 11.6 years; p<0.001). Malignancy was significantly more frequent among women aged ≥40 years than among those aged <40 years (42.6% vs. 15.4%; p=0.004). Positive family history was also significantly associated with malignancy (58.3% vs. 28.4%; p=0.018). Conclusion: Approximately one-third of women presenting with palpable breast lumps had histopathologically confirmed breast malignancy. Older age and positive family history were significantly associated with malignancy. Timely clinical assessment, appropriate imaging, and histopathological confirmation of suspicious breast lumps are important for early diagnosis and management.