A Review On Final Histology And Predictive Factors For Malignancy On Atypical (C3) And Suspicious (C4) Breast Cytology In Hrpz Ii
| dc.contributor.author | Cheah, Sin Dee | |
| dc.date.accessioned | 2017-09-06T02:59:24Z | |
| dc.date.available | 2017-09-06T02:59:24Z | |
| dc.date.issued | 2015 | |
| dc.description.abstract | Introduction: Breast carcinoma is the commonest cancer among females in Malaysia. The majority of patients who attended breast clinic complaint of a breast lump. Triple assessment for all patients is recommended for improved accuracy. Fine needle aspiration cytology ( FNAC ) has been established as the choice of diagnostic method for assessment of breast lump in our country. However, categorization into atypia ( C3 ) and suspicious ( C4 ) causes difficulty in our clinical practice. Objectives: We aim to determine the positive predictive values ( PPV ) of category C3 and C4 , provide cytohistological correlation and assess clinical and imaging factors associated with a malignant histology in a cohort of patients presenting with breast lumps to Breast Clinic, Surgical Department, Hospital Raja Perempuan Zainab II. Methodology: This study was an observational, retrospective cohort study. Data was derived from retrospective record review of patients who have undergone fine needle aspiration cytology of breast lump and reported as C3 or C4. It was conducted at Breast Unit, Surgical Department, Hospital Raja Perempuan Zainab II within a four year period from 2011 until 2014. During the period of study, a total of 169 patients had a breast cytology report in the C3 and C4 group. A sample of 130 patients were included in the study. The positive predictive value of C3 and C4 category was determined after cytohistological correlation analysis performed. They were also evaluated in a number of clinical and imaging variables. Multiple Logistic Regression Analysis was used to estimate the contribution of each variable in predicting a malignant histology. Results: The positive predictive value for C3 is 10% and the positive predictive value for C4 is 82.5%. The commonest benign histology for both C3 and C4 were fibroadenoma and fibrocystic disease. The commonest malignant histology was invasive ductal carcinoma of no special type. Multiple Logistic Regression Analysis revealed hypertension, increasing score on physical examination and increasing BIRADS score on imaging were important independent predictors for a malignant histology outcome. The odds ratio were 68.92 ( 95%CI , 1.02 - 4639.58) , 225.90 ( 95%CI , 4.26 - 11968.63) and 245.701 ( 95%CI , 5.580 - 10819.308 ) respectively. Conclusion: This study has established our centre’s positive predictive value of C3, which was lower than most other centres and C4 , which was consistent with other studies reported in leterature. We also identified hypertension, increasing score on physical examination and increasing BIRADS score on imaging as predictive factors associated with a malignant histology. Therefore , the concordance of each component in triple assessment is important in establishing an accurate preoperative diagnosis of a breast lump. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4475 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | Breast carcinoma | en_US |
| dc.subject | is the commonest cancer. | en_US |
| dc.title | A Review On Final Histology And Predictive Factors For Malignancy On Atypical (C3) And Suspicious (C4) Breast Cytology In Hrpz Ii | en_US |
| dc.type | Thesis | en_US |
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