Department of Surgery, Alex Ekwueme Federal University Teaching Hospital; Faculty of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria.
Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi; Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Niger J Clin Pract. 2021 Jan;24(1):69-74. doi: 10.4103/njcp.njcp_540_19.
Breast lump is a very common problem in the surgical units of many hospitals. Considering our unique socio-cultural and economic peculiarities, the ideal initial preoperative diagnostic tool for breast diseases should be cost-effective, simple with minimal physical and psychological trauma.
This study aimed to evaluate the diagnostic accuracy of Fine Needle Aspiration Cytology (FNAC) in the management of palpable breast lesions in our center.
This is a prospective study that lasted for one year. Fine needle aspiration cytology was done after clinical examination of all patients who gave consent. Open surgical biopsy was used as a reference standard.
One hundred and fifteen patients were enrolled. We found that unsatisfactory smears (C1) were seven (6.1%), benign smears (C2), 57 (49.6%), atypical smears (C3), five (4.3%), suspicious of malignancy smears (C4), six (5.2%) and unequivocally malignant smears (C5), 40 (34.8%). Fine needle aspiration cytology achieved high sensitivity (90.4%), specificity (93.7%), positive predictive value (92.2%), negative predictive value (92.2%) and overall diagnostic accuracy (92.2%) for breast lumps in this study. The false positive and negative rates of 7.8% each are both higher than values recommended by National Health Services Breast Screening Program (NHSBSP) of United Kingdom.
In view of the high sensitivity, specificity and overall diagnostic accuracy combined with early retrieval of pathologic results on first clinic visit reported in this study, FNAC should become a useful tool in the management of breast lumps in our center.
乳房肿块是许多医院外科病房中非常常见的问题。考虑到我们独特的社会文化和经济特点，用于诊断乳房疾病的理想初始术前诊断工具应该具有成本效益、简单、对身体和心理的创伤最小。
本研究旨在评估细针穿刺细胞学（FNAC）在我们中心对可触及乳房病变的诊断准确性。
这是一项为期一年的前瞻性研究。对所有同意的患者进行临床检查后，进行细针抽吸细胞学检查。开放性手术活检用作参考标准。
共纳入 115 例患者。我们发现不满意的涂片（C1）为 7 例（6.1%），良性涂片（C2）为 57 例（49.6%），非典型涂片（C3）为 5 例（4.3%），疑似恶性涂片（C4）为 6 例（5.2%）和明确恶性涂片（C5）为 40 例（34.8%）。细针穿刺细胞学检查对乳房肿块的灵敏度（90.4%）、特异性（93.7%）、阳性预测值（92.2%）、阴性预测值（92.2%）和总体诊断准确性（92.2%）均较高。假阳性率和假阴性率分别为 7.8%，均高于英国国民保健署（NHSBSP）推荐的数值。
鉴于本研究报道的高灵敏度、特异性和总体诊断准确性以及首次就诊时即可快速获得病理结果，FNAC 应该成为我们中心管理乳房肿块的有用工具。
