THE CORRELATION BETWEEN FINE NEEDLE ASPIRATION CYTOLOGY OF PALPABLE BREAST LESIONS AND HISTOLOGIC DIAGNOSIS IN ILE-IFE. A ONE YEAR PROSPECTIVE STUDY

Abstract

Background; Breast cancer is the commonest form of cancer that
is seen in Nigerian women. A one year prospective study on the
classification of fine needle aspiration cytology (FNAC) of palpable
breast lumps with Diff-Quik as well as Haematoxylin and eosin
stains using the United Kingdom National Health Service Breast
Screening Programme (UKNHSBSP) was carried out. The aim of this
study is to classify palpable breast lesions cytologically and to
compare these cytological reports with histological reports of same
lesions. It also aims at determining the sensitivity of fine needle
aspiration in diagnosing palpable breast lesions.
Method: A one year prospective study of all patients that presented
with palpable breast lumps was done. Fine needle aspiration for
cytology was carried out by the primary investigator on these lumps
and the aspirates were smeared on slides. Some of the slides were
air-dried and stained with Diff-Quik and the remaining slides were
immediately fixed in 95% alcohol and sent to the laboratory for
staining with haematoxylin and eosin. The two results were
classified cytologically using the UKNHSBSP and then compared.
The cytological diagnoses were also compared to histological results
derived from biopsies or mastectomy specimens of same lesions.
The cytological grading of the malignant breast smears using the
Robinson’s cytological grading system was compared with the
Nottingham’s grading of the malignant lesions diagnosed
histologically.
Results: A total of 164 cytological reports were obtained from 153
patients during the study period. The patients seen during the
study period were between the ages of 15-86years (Mean 42.3±15.8
SD).Fifty (50.6%) were reported as benign (C2) and 31.7% were
reported as malignant(C5). About 7.8% and 8.5% were reported as
inadequate(C1) and suspicious for malignancy respectively.
The peak age range of presentation of benign lesions was 20-29
years while that for malignant was 40-49 years.
The concordance rate between reports obtained from Diff-Quik
stain and haematoxylin and eosin was 100%. Eighty-seven (53%)
histological reports of the 164 cytological reports were available
during the study period .There was good correlation between
cytological and histological diagnosis as sensitivity of FNAC for
benign lesions was 97.3% and the sensitivity for malignant lesions
was 100%. The concordance rate between cytological grading using
Robinson’s cytological grading and Nottingham’s histological
grading system was 75.8%.
Conclusion: Fine needle aspiration cytology of palpable breast
lesions has a high predictive value for the histological diagnosis of
same lesions especially when performed by an experienced
cytopathologist.

THE CORRELATION BETWEEN FINE NEEDLE ASPIRATION CYTOLOGY OF PALPABLE BREAST LESIONS AND HISTOLOGIC DIAGNOSIS IN ILE-IFE. A ONE YEAR PROSPECTIVE STUDY