ROLE OF TRIPLE ASSESSMENT TEST TO IMPROVE THE DIAGNOSTIC YIELD OF FINE NEEDLE ASPIRATION REPORTING FOR BREAST CARCINOMA

K.A. AL-SINDI¹, S.K. AL-SAAD², M.H. BUKHARI^3
1King Hamad University Hospital, Bahrain.
²Department of Basic Sciences, Fatima University, Livingston Manor, New York, USA.
³Department of Basic Sciences, Fatima University, Livingston Manor, New York, USA.

Received : 16-08-2014     Accepted : 09-10-2014     Published : 03-12-2014
Volume : 3     Issue : 3       Pages : 85 - 88
J Pathol Res 3.3 (2014):85-88

Keywords : FNAC, mammography, Frozen Section, Histopathology, Lump Breast. Breast Cancer
Academic Editor : Dr Kanwal Saba; R. L. Schmidt
Conflict of Interest : None declared

Background: Fine needle aspiration cytology (FNAC) is a simple procedure that, when done in the lab under a trained cytologist, the correct diagnosis can be given with ease. Aims & Objective: The aim of the study is to determine the accuracy of fine needle aspiration cytology (FNAC) in breast cancer diagnosis, the percentage of false negative cytology in our patients, and to confirm the importance of FNAC as part of the triple testing. Method: The 162 breast cancer patients were reviewed from 2000-2012 in different hospitals in Bahrain. The FNAC results were divided into five groups, according to the report, from C1 to C5. The C1 result was an inadequate sample. C2 & C3 results were benign and likely benign samples. C4&C5 were the malignant results. All of these patients had triple testing (physical examination, radiological imaging and fine needle aspiration cytology) as part of their diagnostic assessment. FNAC results were compared to the provisional clinical assessment and mammography beside histopathology. Results: 10/162 patients (6.17%) with C2 and C3 results were considered false negative FNAC. These breast cancer patients were diagnosed by the other components of the triple test.148/162 patients were C4 and C5 results. This meant that the accuracy rate in diagnosing breast cancer with FNAC was 91.358% and the false negative rate was 6.17%. All these false negatives were correctly diagnosed in adding two other modalities of triple testing i,e, clinical assessment and radiological imaging (mammography). Conclusion: In spite of effectiveness, simplicity and validity of fine needle aspiration cytology (FNAC) in the diagnosis of breast cancers, it is still needs the expertise of cytologists, availability of on-site reporting facilities and instant staining techniques to approach the correct diagnosis of breast cancer. The evaluation of breast lumps with the use of triple assessment test to improve the diagnostic yield of FNAC reporting for breast carcinoma by reducing the false negative results.