Radiological and histopathological correlation of giant breast mass

AIMS –

To demonstrate mammographic and ultrasound findings of giant breast masses  and assigning BIRADS category  . To correlate radiological findings with histopathological findings.

Material and methods –

Retrospective observational study of  50 womens with giant breast mass ( more than  5cm in size ) were evaluated with mammography and ultrasound  with assigning of BIRADS category .  USG guided true cut biopsy was done and histopathological diagnosis was correlated with radiological diagnosis.

Result-

Mean age of  50 females was 49.6 years  and mean size of breast lesions were 66.5 x 63.8 x 63.1 mm . There was concordance between BIRADS category assigned and the histopathology.  60 % of cases were infiltrative carcinomas and  BIRADS 5 , 4 C  and 4 B  were assigned to 90% of  such cases. 18 % cases  were of phyllodes, 12 % being benign and 6 % being malignant variety. BIRADS 3, 4 A and 4 B were assigned to benign phylloides and BIRADS 4B and 4C to malignant phylloides. For Giant fibroadenoma ( 6% ) ,BIRADS 3 and 4A was assigned . In other cases of clear cell carcinoma ( 2 %), mixed mucinous carcinoma( 2% ), spindle cell carcinoma ( 2 % )  ,lobular carcinoma ( 4 % )  and DCIS ( 4 % ) , BIRADS 5 and  4 C was assigned .

Conclusion –

Majority of giant breast masses were of  malignant variety, followed by phyllodes, and giant fibroadenoma. The mean size of lesions was greatest for malignant phyllodes. There was a strong agreement between radiological findings and histopathological results in differentiating between malignant and benign lesions. However, distinguishing between various subtypes based solely on imaging proved challenging, particularly in differentiating benign from malignant phyllodes, where clinical knowledge and lesion size becomes  significant.