Syed Qaiser Husain Naqvi, Rafique Ahmed Memon, Jan Muhammad Memon, Nazar Ali Memon, Anwar Ali Akhund, Tabinda Taqi.
FNAC: a preoperative diagnostic modality in breast lump.
Med Channel Jan ;13(4):48-50.

OBJECTIVE : To evaluate the usefulness of Fine Needle Aspiration Cytology (FNAC) as a preoperative diagnostic modality for breast lump. DESIGN : A prospective cross-sectional study. SETTING : Department of pathology, Nawabshah Medical College Nawabshah. DURATION : January 2003 to June 2007. METHODOLOGY : A total number of 276 female patients were included in the study, haying age between 15 to 76 years with a mean age 46.2 years. The patients were collected from various out patient departments and wards of Nawabshah Medical College & Hospital and also from the private clinics, having history of palpable breast lesion of various duration. FNAC was performed with 22 gauge needle attached with 10 nil syringe and without using local anesthetic. The cytological diagnosis was compared with the histological findings of excisional biopsy specimen in all cases. RESULTS : The benign cytological findings were observed in 168(60.9%) patients, among these 104 cases were diagnosed as fibroadenoma, 12 cases were diagnosed as chronic non-specific mastitis, 16 cases were diagnosed as chronic suppurative mastitis. 04 case was diagnosed as tuberculosis, 08 cases were diagnosed as fat necrosis, 04 cast was diagnosed as lactational adenoma, and 20 cases were diagnosed as benign ductal hyperplasia with out atypia. 24(8.7%) cases shows suspicious abnormality and out of these, 12 cases were diagnosed as atypical ductal hypoplasia, and 12 shows features of invasive ductal carcinoma. 84(30.4%) cases were diagnosed as highly suggestive of malignancy, and among these 76 cases shows features of invasive ductal carcinoma, 08 cases shows features of invasive lobular carcinoma. The histological diagnosis of excisional biopsy examination confirms the cytological results, except four cases of chronic suppurative mastitis, which was diagnosed as the cases of tuberculosis, eight cases of ductal hyperplasia and four cases of atypial ductal hyperplasia were diagnosed as cases of invasive ductal carcinoma. No false positive case observed, only 16(5.8%) false negative cases were diagnosed. The sensitivity for cancer was 100%, and specificity was 85.7%. CONCLUSION: FNAC is an initial important diagnostic tool in patients having palpable breast lesion, specially in those rural areas where the surgical facilities are not available.

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