Utility of Ultrasound Guided Versus Conventional Fine-Needle Aspiration Cytology in Diagnosing Breast Malignancy Among Patients With Palpable Breast Lumps at Bugando Medical Centre Mwanza Tanzania.
- Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2019
- xi; 55 Pages Includes Index
Abstract:
Background: Breast lump is the commonest presentation for both benign and maligant breast condtions. Both ultrasound guided and conventional fine needle aspiration cytology (FNAC) has been used for diagnosing of breast malignancy among patients with palpable breast lumps. This study compared diagnostic utility of ultrasound guided versus conventional FNAC in pre-operative diagnosis of breast malignancy among patients with palpable breast lump at Bugando Medical Centre in Mwanza northern west Tanzania.
Method: This was a hospital based cross sectional study, combined both retrospective from January 2017- june2018 (18months) and prospective from July 2018 –June 2019 (11months).
Results: During the study total of 354 patients were enrolled in which 200(56.5%) patients were studied retrospectively and the remaining 154 (42.5%) patients were studied prospectively. The male to female ratio was 1:31.2 and diagnosis age were from 8 to 87 years with a median age of 40 years [Interquartile range of 25 to 52 years]. 37.9% of patients had malignant lesions with median age of 51 years [IQR, 41 to 60 years], while 62.1% of patients had benign lesions with median age of 29.5years [IQR, 22 to 50 years]. This difference was statistically significant (X2 = 81.70, p = 0.000). The diagnostic utility (Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy) for conventional FNAC were 86.7%, 95.7%, 93.5%, 91.1% and 92.0% respectively and diagnostic utility (Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy) for ultrasound guided FNAC were all 100% respectively. The kappa statistic for conventional and ultrasound guided FNAC were 0.83 and 1.0 respectively, showing almost perfect agreement with histological examination.
Conclusion: From this study both ultrasound guided and conventional FNAC have shown almost perfect agreement with histological examination. However, ultrasound guided FNAC has slightly higher diagnostic utility relative to conventional FNAC in diagnosing breast malignancy. Thus, ultrasound guided and conventional FNAC may be used interchangeably in our settings as they all have shown good diagnostic utility, and ultrasound guided FNAC may be spared for use in nonpalpable and cystic breast lesions since it is not readily available as it need interventional radiologist.
Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : www.bugando.ac.tz