Analysis Of Utility Of Fine Needle Aspiration

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Utility of Fine Needle Aspiration in Diagnosing Breast lesions among Sudanese Females. A Cyto - Histological correlation.
Aghapy E. Siddig, Emmanuel E. Siddig, Ali Edreis, Ahmed H. Fahal.

Introduction:
Dramatically, Breast cancer is the most commonly diagnosed cancer among women worldwide, and is ranked second only to lung cancer as the leading cause of cancer deaths (Jemal et al., 2009). Although, the incidence of breast cancer in Sub-Saharan African counties is low compared that in developed countries (Pakin et al., 1999), the cancer picture in Sub-Saharan Africa and especially in Sudan is changing. Lately, breast cancer incidence and mortality has been raised. Fine Needle Aspiration (FNA) is one of the important components of ‘triple approach’,
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Pearson Chi Square Test was used to test association between variables. Ethical considerations: ethical approval was obtained from ethics committee at Faculty of Medical Laboratory Science, University of Khartoum. Both written and verbal consent were obtained from each individuals enrolled on this study.
Results:
FNA materials were obtained from 117 female patients, their age ranging from 15 – 78, with mean age of 44 years old. The diagnosis of 117 FNA smears was as follow: 96 (82.1%) were benign, 3 (2.6%) were suspicious and 18 (15.4%) were malignant breast lesions.
Subsequent Histopathological diagnosis were performed in all cases, FNA cytology revealed 95% sensitivity, and 97.9% specificity. Of 96 benign cases in cytology, one case was found malignant in histopathology report. Of the 3 suspicious cases in cytology, one case was found to be malignant in histopathology report and the other two cases were found benign. Of 18 malignant cases in cytology, all were found malignant in histopathological reports.
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However, one case which was misinterpreted as a Fibroadenoma by FNA was later on, diagnosed as a Ductal carcinoma insitu (DCIS) on doing a histopathological examination. The cytological features of the smear comprised a hypercellular smear, sheets of cohesive epithelial cells, branching antler – horn of epithelial, and numerous bipolar nuclei scattered with in the background, after reviewing histopathology comment we carefully examined the cytological smear in which we find a small population of pleomorphic cells admixed with a dominant population showing features of Fibroadenoma. Our finding agrees with that of Dejmek and colleges, they also commented that very rarely carcinoma can arise in a Fibroadenoma, thus careful screening for malignant cells is required in this setting (Dejmek et al., 1991).
In the present study, all the 18 cytologically diagnosed malignant cases were confirmed as malignant on subsequent histopathological examinations. So, in our study, a 100% Cyto-histopathological correlation was observed for malignant lesions this is in agree with other studies conducted by. Zhang Qin et al., 2004; Mohammed et al., 2005; and Tiwari M, 2007, had also observed the same results in his

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