Original Research Article
Year: 2017 | Month: June | Volume: 7 | Issue: 6 | Pages: 17-23
The Role of FNAC in the Management of Breast Diseases in Abakaliki, South-East Nigeria
U.E. Eni1, F. Iyare2, I. Sunday-Adeoye3, M.E. Isikhuemen2, K.C. Ekwedigwe2, M.O. Eliboh2
1Department of Surgery, 3Department of Pathology,
Federal Teaching Hospital, Abakaliki, Nigeria.
2National Obstetric Fistula Centre, Abakaliki, Nigeria.
Corresponding Author: M.E. Isikhuemen
ABSTRACT
Background: Breast lesions are common presentations to the surgeon. However, their effective diagnosis and management depends on the specialist skills of many disciplines. Presently the triple assessment regimen is the recommended approach for the investigation of palpable or impalpable lesions detected by imaging. Fine needle aspiration cytology (FNAC) is frequently part of our initial assessment of breast lesions as histology report takes much longer time to obtain in our practice.
The aim of this study was to document the effectiveness of FNAC in our practice of triple assessment regimen in the management of breast diseases.
Methods: This was a 30 month prospective analysis of 329 patients seen at our breast clinic at the National Obstetric and Fistula Centre, Abakaliki between June 2013 and December 2015. This was done under the auspices of an intervention study including free FNAC when indicated.
Results: The FNAC report included 250(76%) negative for malignancy (benign), 64 (19.5%) positive for malignancy and 15 (4.6%) suspicious for malignancy. Of the 250 cases reported as benign at FNAC 10 cases were confirmed malignant at histology. All 64 cases that were positive for malignancy were concordant with histology. Out of the 15 cases reported as suspicious for malignancy 3 were benign on histology. FNAC had a sensitivity of 88.4% and a specificity of 98.8%. The positive predictive value was 96.2%; the negative predictive value was 96%. The diagnostic accuracy was 96.1%.
Conclusion: FNAC is highly sensitive and specific in the evaluation of breast lesions in our practice. This should lead to accurate diagnosis in the context of triple assessment in the majority of cases to permit definitive treatment.
Key words: Breast lesions, triple assessment regimen, FNAC, Abakaliki, South East Nigeria.