An Audit of Fine Needle Aspiration Cytology Diagnosis of Breast Lesions in Calabar, Nigeria

Abstract

Aim: The aim of this study is to determine the reliability of fine needle aspiration cytology (FNAC) of the breast as rapid cheap and quick diagnostic tool in an underdeveloped setting. Study Design: A descriptive retrospective study of breast FNAC results matched with the open biopsy results of 93 breast lesions between January 2012 to October 2014. Place and Duration of Study: University of Calabar teaching hospital, January 2012 to October 2014. Methodology: Data and archival slides of FNAC and their matched histological slides were analysed. The FNAC diagnosis were compared with the histological diagnosis, which are assumed to be the gold standard. The FNAC concordance with histological diagnosis was tested for quality by comparing our results to the United Kingdom's NHS breast cancer screening programme (NHSBSP) standard of quality. Results: Ninety three patients (93) had FNAC of the breast followed by open biopsy with histology, comprising one male 92 females giving a male female ratio of 1:0.01. The complete sensitivity 90.7%, absolute sensitivity 72.1% (95% CI: 55.3-84.7%), and full sensitivity, 88.1% (95% CI: 74.4 - 96.0%) of our test, met the performance target of NHSBSP guidelines. However, the false negative rate and the false positive rate of our test results did not meet the NHSBSP performance target. Conclusion: Fine needle aspiration cytology diagnosis of the breast offers a cheap and quick means of diagnosis, however more needs to be done to improve its diagnostic reliability and safety in Calabar.