Study of Clinico-Radiological Examination and Histopathological Examination in Management of Breast Lump

Sachin Sehrawat; Dipankar Naskar; Kanwar Singh Goel; Rajesh Arora; Khushi; Sanni Lathiya; Aman Yadav

Authors

Sachin Sehrawat Postgraduate Resident, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Dipankar Naskar Associate Professor, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Kanwar Singh Goel Professor, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Rajesh Arora Professor, Department of Radiology, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Khushi 1Postgraduate Resident, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Sanni Lathiya Postgraduate Resident, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.
Aman Yadav Postgraduate Resident, Department of General Surgery, SGT Hospital, Faculty of Medicine and Health Sciences, SGT University, Gurugram, Haryana, India.

Abstract

Background: Breast lumps are among the most common presenting complaints in surgical outpatient departments, encompassing a wide spectrum from benign fibrocystic disease to invasive malignancy. Accurate early differentiation is critical to prevent diagnostic delays, reduce unnecessary surgery, and optimize patient outcomes. The triple assessment – comprising clinical breast examination (CBE), radiological imaging (ultrasonography [USG]/mammography), and fine needle aspiration cytology (FNAC) – is the internationally recommended standard for evaluating breast lumps. However, institution-specific data validating its performance in the Indian clinical context remain sparse. Materials and Methods: This prospective observational study enrolled 50 patients with palpable breast lumps at SGT Medical College, Gurugram, between 2024 and 2026. All patients underwent structured CBE, radiological assessment (USG ± mammography) classified by the Breast Imaging Reporting and Data System (BI-RADS), and FNAC classified by the C1–C5 cytology grading system. Histopathological examination (HPE) served as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and Cohen’s kappa (κ) were computed. Results: Of 50 patients (mean age 38.6 ± 9.4 years), 32 (64%) had benign and 18 (36%) had malignant lesions on HPE. Key malignancy-associated clinical features included puckering/dimpling (66.7% vs. 9.4%; P < 0.001), peau d’orange (50.0% vs. 3.1%; P < 0.001), and axillary lymphadenopathy (72.2% vs. 9.4%; P < 0.001). All BI-RADS 5 lesions (100%) were histologically malignant. FNAC: Sensitivity 94.4%, specificity 90.6%, accuracy 92.0%. Kappa values: Clinical κ = 0.71, radiology κ = 0.79, FNAC κ = 0.84, triple assessment κ = 0.88. Conclusion: Integrated triple assessment achieves near-perfect concordance with histopathology (κ = 0.88) and represents the optimal diagnostic strategy for breast lumps. FNAC is the most accurate single modality. Multicentric studies with larger cohorts are warranted.