Pillay Sumana, Cheddie Shalen, Moodley Yoshan
University of KwaZulu-Natal College of Health Sciences, Department of Surgery.
Madadeni Hospital.
Afr Health Sci. 2018 Jun;18(2):273-280. doi: 10.4314/ahs.v18i2.11.
The triple assessment of clinical breast exam (CBE), fine needle aspirate cytology (FNAC) and breast ultrasonography (US) is used in many settings for the diagnosis of fibroadenoma (FA). The diagnostic accuracy of FNAC and US for FA in South African (SA) women with palpable breast masses (PBM) is unknown.
To report the diagnostic accuracy of FNAC/US for FA in SA women with PBM.
We conducted a retrospective pilot diagnostic study of 91 women who presented with PBM to a SA regional academic hospital. Data for CBE, US, unguided FNAC, and open biopsies was collected from study participant medical records and analyzed using diagnostic accuracy tables.
A total of 57/91 (62.6%) study participants had uninterpretable FNAC results. No study participants had uninterpretable US results. The overall diagnostic accuracy of FNAC for FA was 36.3% (95% Confidence Interval - CI: 27.1-46.5%). The overall diagnostic accuracy of US for FA was 83.5% (95% CI: 74.6-89.8%).
The yield of interpretable test results for FNAC was poor in our study. The diagnostic accuracy of US for FA appears to be superior to that of FNAC. Omission of FNAC from the triple assessment in our setting should be considered.
临床乳腺检查(CBE)、细针穿刺抽吸细胞学检查(FNAC)和乳腺超声检查(US)的三联评估在许多情况下用于诊断纤维腺瘤(FA)。在南非(SA)有可触及乳腺肿块(PBM)的女性中,FNAC和US对FA的诊断准确性尚不清楚。
报告在南非有PBM的女性中FNAC/US对FA的诊断准确性。
我们对91名到南非一家地区学术医院就诊的有PBM的女性进行了一项回顾性试点诊断研究。从研究参与者的病历中收集CBE、US、非引导性FNAC和开放活检的数据,并使用诊断准确性表格进行分析。
共有57/91(62.6%)的研究参与者FNAC结果无法解读。没有研究参与者US结果无法解读。FNAC对FA的总体诊断准确性为36.3%(95%置信区间 - CI:27.1 - 46.5%)。US对FA的总体诊断准确性为83.5%(95%CI:74.6 - 89.8%)。
在我们的研究中,FNAC可解读的检测结果的阳性率较低。US对FA的诊断准确性似乎优于FNAC。在我们的环境中,应考虑在三联评估中省略FNAC。