Okoli Chinedu, Ebubedike Uzoamaka, Anyanwu Stanley, Chianakwana Gabriel, Emegoakor Chinemelum, Ukah Cornelius, Umeh Eric, Onwukamuche Micheal, Egwuonwu Ochonma, Ihekwoaba Eric
Department of Surgery, Nnamdi Azikiwe University, Anambra, Nigeria.
Department of Radiology, Nnamdi Azikiwe University, Anambra, Nigeria.
Eur J Breast Health. 2020 Mar 31;16(3):171-176. doi: 10.5152/ejbh.2020.5075. eCollection 2020 Jul.
There is increasing tendency to multidisciplinary care of patients with of breast lesions. This study sought to evaluate the initial experience of the diagnostic arm of a new breast program in a resource limited setting.
In 2015, we commenced the pilot phase of an IRB-approved breast care protocol. As part of the protocol's diagnostic arm, an ultrasound-guided breast core biopsy training was implemented. Eligible patients were clinically evaluated and underwent CNB using 16G needle under US guidance. The procedure was rated by the participants and histopathological results compared with surgical specimens.
Eighty six participants (18.22%) with 113 palpable breast lesions completed the study. The diagnostic accuracy, sensitivity, and specificity were 94.44%, 92.86%, and 95.83% respectively. Unweighted kappa-coefficient (k) agreement between histopathology of core biopsy and surgically excised specimens, were 0.798 (95% CI of 0.69 - 0.90) and 0.801 (95% CI of 0.71-0.92) for benign and malignant breast lumps respectively. The procedure was well accepted and all the patients were willing to accept a repeat CNB and would recommend it.
Despite the prevailing challenges, co-ordinated team diagnosis is feasible and may result in the modest improvement in the diagnostic accuracy of breast lesions and patient satisfaction.
对乳腺病变患者进行多学科护理的趋势日益增强。本研究旨在评估在资源有限的环境中一个新的乳腺项目诊断环节的初步经验。
2015年，我们启动了一项经机构审查委员会批准的乳腺护理方案的试点阶段。作为该方案诊断环节的一部分，实施了超声引导下乳腺粗针活检培训。符合条件的患者接受临床评估，并在超声引导下使用16G针进行粗针活检。参与者对该操作进行评分，并将组织病理学结果与手术标本进行比较。
86名参与者（18.22%）有113个可触及的乳腺病变，完成了研究。诊断准确性、敏感性和特异性分别为94.44%、92.86%和95.83%。对于良性和恶性乳腺肿块，粗针活检的组织病理学与手术切除标本之间的非加权kappa系数（k）一致性分别为0.798（95%可信区间为0.69 - 0.90）和0.801（95%可信区间为0.71 - 0.92）。该操作得到了很好的接受，所有患者都愿意接受重复粗针活检并会推荐它。
尽管存在诸多挑战，但团队协作诊断是可行的，可能会使乳腺病变的诊断准确性和患者满意度略有提高。
