Diagnostic Accuracy of Fine Needle Aspiration Cytology in Breast Masses among Children and Adolescents Aged Below 21 Years of Age- A Cross-sectional StudyCorrespondence Address :
Dr. K Amita,
BG Nagara, Nagamangala Taluk, Mandya District-571448, Karnataka, India.
Introduction: Breast diseases in paediatric and adolescence are unusual. Fine Needle Aspiration Cytology (FNAC) has an important role in triaging breast masses, more so in younger population, wherein preoperative accurate diagnosis has significant impact on selecting and planning treatment. Role of FNAC in breast lesions amongst children and adolescents has not been explored much.
Aim: To study the role of FNAC in diagnosis of breast lesions in children and adolescents.
Materials and Methods: A cross-sectional study was conducted between June 2017 to May 2019 at Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India. All the patients presenting with breast lesion aged below 21 years, referred to FNAC clinic during this period were included in the study. The diagnoses were categorised as inflammatory, benign, atypia, suspicious and malignant. Cytohistopathology concordance was attempted wherever possible. Analysis was done using Statistical Package for the Social Sciences (SPSS) software version 17.0.
Results: Out of total 45 cases, 37 (82.22%) were females and 8 (17.78%) were males. Breast lesions in paediatric and adolescents accounted for 15.20% (45/296) of total breast FNAC performed during the study period. The morphologic spectrum seen most commonly was fibroadenoma (FA) 62.22% (2-8/45), benign breast disease 8.88% (4/45), mastitis 4.44% (2/45). Morphologic variations observed in FA were epithelial hyperplasia 32.14% (9/28), cystic change 28.57% (8/28), hyper cellular stoma 21.42% (6/28), multinucleate giant cells 32.14% (9/28), apocrine change 14.28% (4/28), adenosis 10.71% (3/28), columnar cell change 10.71% (3/28), squamous metaplasia 3.57% (1/28) and atypia 3.57%(1/28). Histopathologic correlation was obtained in 31 cases (68.88%). Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of FNAC was found to be 50, 100%, 100%, 96.6%, 96.77%, respectively.
Conclusion: Majority of the breast lesions in paediatric and adolescents are benign in nature with FA being the most common. FNAC had high specificity and diagnostic accuracy, thereby establishing its role in selecting appropriate treatment for this age group of patients.
Breast neoplasms, Cytology, Paediatric
Date of Submission: Sep 26, 2020
Date of Peer Review: Dec 05, 2020
Date of Acceptance: Jun 12, 2021
Date of Publishing: Jul 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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• Plagiarism X-checker: Sep 26, 2020
• Manual Googling: Jun 10, 2021
• iThenticate Software: Jun 30, 2021 (13%)
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