Breast cancer is the second most commonly diagnosed cancer in the world followed by lung cancer and is, by far the most frequent cancer among women with an estimated 2.1 million newly diagnosed female breast cancer cases in 2018, contributing for about 11.6% of the total cancer incidence burden, accounting for almost 1 in 4 cancer cases among women.1,2 In India, breast cancer is the most frequently observed cancer (14% of the total cases) and it is the leading cause of cancer death (11•1% of the total cases) followed by cancers of lip and oral cavity.3,4 Among females, breast cancer is the most commonly diagnosed cancer (27•7%) followed by the cancers of cervix uteri. It is also the leading cause of cancer death in women (23•5%) followed by cancers of cervix uteri in India.3-7 The demographic characteristics of breast cancer patients are important for understanding the distribution of the disease across different population groups. Age is one of the most established risk factors, with the incidence generally increasing with advancing age. However, breast cancer also affects younger women, and the age distribution of patients may vary across geographical regions and populations. Other relevant demographic variables include place of residence, educational attainment, occupation, marital status, and socioeconomic background. These factors may influence awareness of breast cancer, recognition of symptoms, health-seeking behaviour, access to diagnostic facilities, and the timeliness of presentation to healthcare institutions.8,9 Consequently, evaluating the demographic profile of patients attending a healthcare facility can help identify population groups that may require targeted awareness and early-detection interventions. The development of breast carcinoma is multifactorial and involves an interplay of hormonal, reproductive, genetic, lifestyle-related, and environmental factors. Established risk factors include increasing age, a family history of breast cancer, inherited pathogenic variants in genes such as BRCA1 and BRCA2, early menarche, late menopause, older age at first full-term pregnancy, nulliparity, exposure to menopausal hormone therapy, alcohol consumption, obesity, and previous exposure to ionizing radiation.10 However, the presence of identifiable risk factors is not universal, and many women diagnosed with breast cancer do not have a known family history or a clearly identifiable modifiable risk factor.11 Therefore, the absence of conventional risk factors should not be considered sufficient to exclude the possibility of breast malignancy. A systematic assessment of patients' demographic characteristics, personal and family history, reproductive profile, and associated clinical factors is important for a comprehensive understanding of the disease in a particular population. In this context, the present cross-sectional study was undertaken to assess the clinical and demographic profile of patients with breast carcinoma. By documenting the sociodemographic characteristics, relevant clinical history, presenting symptoms, and other available disease-related parameters, the study aims to describe the pattern of breast carcinoma among patients attending the study centre. The findings may contribute to a better understanding of the local disease profile and provide baseline information for future research, early-detection initiatives, and improvements in the clinical evaluation and management of breast carcinoma.

The present cross-sectional study was conducted at the Department of Pathology of KLE Academy of Higher Education and Research (KAHER) University, Jawaharlal Nehru Medical College (JNMC), Belagavi. Inclusion criteria: • Histopathologically confirmed malignant breast lesions. • Specimens with adequate fixation and sufficient tissue for histopathological evaluation. • Cases with available clinical and demographic information relevant to the study, wherever applicable. Exclusion criteria: • Specimens which had not been fixed optimally. • Benign breast lesions • Male breast carcinoma Sample Size Calculation: The sample size was calculated using the formula 4pq/d2 p– Expected prevalence q- 100-p Sample error (10) Substituting the values in the above formula we obtained a sample size of 40. Ethical clearance: The present study was approved by Jawaharlal Nehru Medical College's Institutional Ethics Committee on Human subjects Research. Case Selection: The clinicopathological parameters, including age, family history, tumor size, Lymph nodes status, clinical diagnosis were obtained from the patient's outpatient and inpatient records and requisition forms as per proforma given. The specimens were adequately fixed in 10% neutral buffered formalin. Four to five-micron thick sections were cut from paraffin embedded blocks. One section from each block was taken for Haematoxylin and eosin staining. The Hematoxylin and Eosin stained slides were evaluated for: • Diagnosis of lesion • Pattern of growth • Invasion The histopathological findings were interpreted in conjunction with the available clinical information. Only adequately fixed specimens with sufficient tissue for reliable assessment were included in the analysis. Statistical Analysis: The collected data were entered into a spreadsheet and analysed using appropriate descriptive statistical methods. Continuous quantitative variables, such as age and tumour size, were summarised as mean and standard deviation when their distributions were approximately normal. For skewed continuous variables, the median and interquartile range were considered more appropriate. Categorical variables, including family history, clinical presentation, histopathological diagnosis, and lymph node status, were expressed as frequencies and percentages

The age of the patients with carcinoma breast ranges from 30 to 87 years. Mean age was 56.48 years. Majority of the patients, 13 (32.50%) belonged to age group of 50-59 years. The family history was present in 16 cases(40%) and was absent in 24 cases(60%) out of 40 cases (table1). Table 1: Age distribution and family history of patients with breast carcinoma (n=40) Age (Years) Number Percentage 30 – 39 3 7.50 40 – 49 8 20.00 50 – 59 13 32.50 60 – 69 11 27.50 ≥ 70 5 12.50 Total 40 100.00 Mean±SD 56.48±13.22 Family History Yes 16 40.0 No 24 60.0 The size of the tumor ranged from 2 to 13 cm considering the largest dimension of the tumor. Most of the cases (24 cases) were of the size between >2 cm and 5 cm. Mean tumor size was 4.67 cm. Table 2: Distribution of patients according to size of tumor (n=40) Tumor Size (cm) Number Percentage 2 – 5 24 60.00 5 – 7 11 27.50 ≥ 7 5 12.50 Total 40 100.00 Mean±SD 4.67±2.27 Of the 40 cases, 11 cases (27.50%) had no lymph node metastasis. 15 cases (37.50%) had metastatic deposits in 1-3 lymph nodes and, 6 cases in 4-9 lymph nodes and 8 cases showed metastatic deposits in more than 10 lymph nodes (graph 1). Graph 1: Distribution of patients according to number of lymph nodes showing metastatic deposits (n=40) Among 40 cases of invasive carcinoma breast studied, 32 (80%) cases were of Bloom Richardson grade II and 8 (20%) cases belonged to grade III (graph 2). Graph 2: Distribution of patients according to histological grade of tumor (n=40)

In the present study, majority of the patients were above 50 years of age and mean age was 56 years. The youngest patient was aged 30 years and the oldest patient, 87 years. Majority of the patients; 13 cases (32.50%) were seen to be in the age group of 50-59 years. When compared to Suresh Hedau et al12 study who had a mean age of 41 years, who studied 40 cases of invasive breast carcinoma and most of their cases - 14 cases (35%) were of the age group 40–49 years. The study by Pérez-Vallés et al13, who studied 45 patients with breast cancer had 25 patients upto 45 years and 20 patients above 45 years. In this study, family history was present in 16 cases (40%) and was absent in 24 cases (60%) out of 40 cases. Study done by Verma et al14 shows 6 out of 54 cases (11.1%) with family history which is lower than the present study. In another study by Lambie H et al15 family history was present in 69 out of 100 patients which was higher compared to the present study. In the present study, the size of the tumor ranged from 2 to 13 cm considering the largest dimension of the tumor. Most of the cases (24 cases) were of the size between >2 cm and 5cm. Mean tumor size was 4.67 cm. In the study by Pérez-Vallés et al13, 18 cases out of 45 cases were of tumor size of 2-5 cm. Out of 40 cases, 11 cases (27.5%) had no lymph node metastasis and 29 cases (72%) showed metastatic deposits in the regional lymph nodes. Of these 29 cases 15 cases (37.50%) had metastatic deposits in 1-3 lymph nodes and 6 cases in 4-9 lymph nodes and 8 cases showed metastatic deposits in more than 10 lymph nodes. In the study by Suresh Hedau et al12, 31 (77.5%) of 40 cases had regional lymph node metastasis and 9 of 40 cases (22.5%) had no regional lymph node metastasis and a similar observation was noticed in the present study. Study by Pérez-Vallés et al13, 19 (42%) of 45 cases had regional lymph node metastasis and 26 of 45 cases (58%) had no regional metastasis which was having lower number of metastatic cases when compared to the present study. The cases were evaluated for histological grading as per modified Bloom Richardson (BR) grading system. Out of the 40 cases, 32 (80%) cases were of grade II and 8 (20%) cases were of grade III. In Suresh Hedau et al12 study, 6 (15%) cases of grade I, 22 (55%) cases of grade II and 12 (30%) cases of grade III out of 40 cases. Study by Verma et al14 showed, 27 (50%) cases out of 54 cases were of grade II. In the study by Pérez-Vallés et al13, 21 (47%) cases out of 45 cases belonged to grade to II. These studies correlate with the present study that a maximum number of cases belong to grade II. Limitations: The present study had certain limitations. First, the sample size was relatively small, comprising only 40 cases, which may limit the generalisability of the findings to the wider population of patients with breast carcinoma. Second, the study was conducted at a single tertiary-care institution; therefore, the observed demographic and clinicopathological patterns may not reflect those in other geographical regions or healthcare settings. Third, the cross-sectional design permitted description of the clinical and histopathological characteristics of the study population but did not allow assessment of temporal changes, causal relationships, or long-term outcomes such as recurrence and survival.

The present study describes the demographic, clinical, and histopathological characteristics of 40 patients with breast carcinoma. The majority of patients were aged over 50 years, with the highest proportion belonging to the 50–59-year age group. Most tumours measured 2–5 cm, and regional lymph node metastasis was observed in 72.5% of cases. Histologically, grade II tumours constituted the predominant category, accounting for 80% of the cases. These findings demonstrate the importance of systematic clinical evaluation and histopathological examination in characterising breast carcinoma, including assessment of tumour size, regional lymph node involvement, and histological grade. The frequent occurrence of nodal metastasis in this series underscores the need for timely recognition, appropriate diagnostic evaluation, and comprehensive disease assessment. However, given the small sample size and single-centre design, the results should be interpreted within the context of the study population. Larger multicentre studies are needed to establish more representative clinicopathological patterns and further investigate the relationships between demographic factors and tumour characteristics.

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. 2. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941-53. 3. Dar MA, Sharma KK. Burden of cancer in India: GLOBOCAN 2018 estimates incidence, mortality, prevalence and future projections of cancer in India. J Emerg Technol Innov Res. 2019;6(6):505-14. 4. World Health Organization. Global health estimates 2016: deaths by cause, age, sex, by country and by region, 2000–2016. Geneva: World Health Organization; 2018. 5. Gupta A, Shridhar K, Dhillon PK. A review of breast cancer awareness among women in India: cancer literate or awareness deficit? Eur J Cancer. 2015;51(14):2058-66. 6. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. 7. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2024. Breast cancer fact sheet, GLOBOCAN 2022 estimates. 8. Thakur NA, Humne AY, Godale LB. Delay in presentation to the hospital and factors affecting it in breast cancer patients attending tertiary care center in Central India. Indian J Cancer. 2015;52(1):102-5. 9. Sathwara JA, Balasubramaniam G, Bobdey SC, Jain A, Saoba S. Sociodemographic factors and late-stage diagnosis of breast cancer in India: a hospital-based study. Indian J Med Paediatr Oncol. 2017;38(3):277-81. 10. National Cancer Institute. Breast cancer prevention (PDQ®)–health professional version. Bethesda (MD): National Cancer Institute. Available from: https://www.cancer.gov/types/breast/hp/breast-prevention-pdq 11. World Health Organization. Breast cancer. Geneva: World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer 12. Hedau S, Batra M, Singh UR, Bharti A, Ray A, Das B. Expression of BRCA1 and BRCA2 proteins and their correlation with clinical staging in breast cancer, Journal of Cancer Research and Therapeutics. 2015;11(1):158-163. 13. A Pérez-Vallés, M Martorell-Cebollada, E Nogueira-Vázquez, J A García-García, E Fuster-Diana. The usefulness of antibodies to the BRCA1 protein in detecting the mutated BRCA1 gene. An immunohistochemical study. J Clin Pathol 2001;54:476-80. 14. Verma D, Agarwal K, Tudu SK. Expression of breast cancer type1 and its relation with expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2/neu in breast carcinoma on trucut biopsy specimens. Indian J Pathol Microbiol 2018;61:31-8. 15. Lambie H, Miremadi A, Pinder SE, Bell JA, Wencky P, Paish EC, et al. Prognostic significance of BRCA1 expression in sporadic carcinomas. J Pathol. 2003;200:207-13.