Pattern Of Breast Lumps And Diagnostic Accuracy Of Fine Needle Aspiration Cytology; A Hospital Based Study From Pondicherry, India

摘要

Introduction Breast cancer is the second most common cancer in women. FNAC is simple, rapid and safe method to diagnose breast lumps. FNAC has high sensitivity, specificity and accuracy.Objectives The aim of study was to correlate the FNAC diagnosis with histopathology and to find out the pattern of breast lump, sensitivity and specificity of FNAC in diagnosis of breast lumps in our institution. Method The present study was done in department of Pathology of Sri Venkateshwara Medical college Hospital and research Centre, Pondicherry, India from June 2008 to May 2010. The FNAC was done in 102 cases and histopathology was available in 77 (75.49%) cases for correlation with cytology.ResultsThe result shows 3.92% cases were male while 96.08% female. Age of the patient was range from 16- 52 years with mean age of 30 years. In our study fibroadenoma was most common benign lesion in the breast which account 45.09% of the total breast lesion, and 89.1% seen in the age group of 10-30 yrs. Study includes 9(8.82%) cases of malignancy with mean age of 46 years. The sensitivity and specificity for malignancy were found to be 84.6% and100% respectively.ConclusionFNAC is highly sensitive and specific technique for diagnosis of most of the breast lumps. FNAC can be used preoperatively to avoid unnecessary surgery and discomfort during open biopsy. Introduction In India Cancer of breast is a second most common cancer in the women1. Breast lump is most common presentation in the most of the breast diseases. Most of the cases in breast lesions are benign2. Breast mass in women causes anxiety to herself and her family member, which can be reduced by giving assurance that most of breast lumps are benign and early diagnosis by fine needle aspiration cytology. The FNA first introduced by the Martin and Ellis in 1930.3 The FNAC is highly sensitive, easy to perform and cost effective that can be carried out at outpatient department.4,5 FNA has various benefits over the open tissue biopsy6. Rapid, Reliable. Help in planning of treatment in breast lump. Ability to perform molecular ancillary technique i.e. PR & ER, proliferation antigen (Ki67) & DNA pattern analysis. Accuracy in the diagnosis can be increased by multiple sampling of appropriate sites by Ultrasonography guidance and / or mammographic localisation.7,8 That is why FNAC is regarded as preliminary diagnostic procedure, as a screening procedure with or without Ultrasonography or stereotactic guidance9, or as a follow-up procedure for post mastectomy or lumpectomy10. Fine Needle Aspiration Cytology can also use to diagnose lesions of male breasts such as gynaecomastia and carcinoma, accessory axillary breasts and their lesions, and status of the axillary lymph nodes11, 12. Thus the FNAC have reduce the number of open breast biopsies.13 The aim of this study was to find out the common causes of breast lump and to find out sensitivity and specificity of FNAC of breast lump in our institute. Method The present study was carried out in department of Pathology of Sri Venkateshwara Medical college Hospital and research Centre, Pondicherry, India from June 2008 to May 2010 after taking permission from ethical committee of institution. The patients with palpable breast lump referred from general surgery department in the institution for FNAC were involved in the study. The case history of the patient was recorded, includes Detail history of pain, nipple discharge, ulceration of nipple and duration of lesion. The examination of breast lump was done with recording of size and site of lump, consistency, and fixation to skin and underline tissue, retraction of nipple along with regional lymph node involvement. Consent was taken after due explanation of the procedure and its benefit to the patients. The skin over the breast was wiped with antiseptic solution and spirit, suspected lesion was held with one hand in a position favorable to fine needle aspiration. Procedure is done by using 20 gauze needle fitt