BACKGROUND: Breast diseases are rising in incidence especially in developing
countries. However, most research focuses on breast cancer. Analysing the spectrum of
breast disease will enable establishment of efficient breast clinics within
an existing general surgery out-patient department with minimal additional
investment or personnel whilst providing quality care.
OBJECTIVES: To study the spectrum of breast disease in an urban general
surgical centre in India. To use a `Clinic-within-a-Clinic' model to provide
affordable care and accurate early diagnosis to patients with breast
disorders.
MATERIALS & METHODS: A prospective study was conducted over 1 year at M.
S. Ramaiah Hospital, Bangalore by a single general surgical unit. 903 patients who presented to
the OPD with a variety of breast-related symptoms were included in the study
(896 women and 7 men). Relevant history was taken; the patients were then
examined and investigated according to our protocol and patterns were
recognized.
RESULTS: Benign breast disease formed the majority of the cases (640 patients,
70.87%). The 21-30 years age group had the most patients (272 patients,
30.12%). ANDI was the commonest diagnosis (522 patients, 57.8%). 92
patients (10.18%) were diagnosed with cancer. More than 50% of these
were less than 50 years of age. Majority of the patients (511 patients,
56.58%) could be managed conservatively. The cost of diagnosis and
treatment was found to be a small fraction of that in specialized breast
units of western countries using our `Clinic-within-a-clinic' model.
CONCLUSION: Research on the demographic and clinical pattern of breast disease
can help establish and efficient, effective and affordable diagnostic and therapeutic
systems in developing nations.
