[Accuracy assessment of FNA in diagnosis of palpable breast mass]

ABSTRACT

Due to widespread of palpable breast masses in female and common complications resulted from delayed diagnosis and also with some regards to contradictory reports upon the accuracy of fine needle aspiration [FNA] in comparison with standard method of excisional biopsy this study has been performed on patients with palpable breast mass referred to the Aayatollah Talegheni Hospital between years 2003 and 2005. The present study was based on evaluation of diagnostic methods. Seventy five patients were included in this research and the mean of their age was 44 +/- 10 years [ranged from 20 to 75 years]. FNA was accomplished initially by skin prep with alcohol and holding the lumps between thumb and point fingers. After the needle [No 22-25] was placed into the lump, a continous suction was generated using a 10 ml syring and then multiple in and out needle motions were performed. The collected samples were then smeared on glass slides and allowed to dry out in air and fixed by 96% alcohol. The fixed smears were then stained and examined by a pathologist. Lesions with cystic character were drained and excluded from the study. FNA results were reported according to the latest classification of breast masses as follow c1 inadequate sample, c2 benign, c3 semibenign, c4 semimalignant, c5 malignant [c3 and c4 assumed as indeterminate group]. The total efficiency of FNA for detection of palpable and malignant breast tumor was determined based on, the pathology reports on excisional biopsy [as a gold standard method], the level of sensitivity and specificity, positive and negative predictive values, and also the overall efficiency of FNA. .4 cases of drained cystic lump were eliminated from the study. The amount of sample were inadequate for FNA study in 11 biopsy cases [14.7%]. Nine biopsies [15%] were identified as indeterminate, 43.3% as benign, and 41.7% malignant, which were compatible with the results of excisional biopsy. Therefore 100% [all] of the positive and negative predictive values were obtained. The FNA is a suitable method for diagnosis of malignancy in palpable breast tumor, and hense it can be recommended for this purpose: