Correlation of Risk Factors with Different Reporting Categories of Fine Needle Aspiration Cytology (FNAC) of Palpable Breast Lumps

Abstract

Background: Fine needle aspiration cytology (FNAC) is a well-known and valued technique for estimation of palpable breast masses before any surgery because it is highly sensitive, accurate, specific, and cheap. Most of the time, the risk factors are global, but sometimes there are some local, environmental, ethnic and genetic factors which could be different in different communities. Objective: To study different known risk factors of breast cancer in the population of Faisalabad and correlate it with FNAC categories and track significant factors in the local population. Study Design: Descriptive retrospective study. Settings: Meezan lab and University Medical and Dental College, Faisalabad Pakistan. Duration: June 2014- June 2019 (5 years). Methodology: A total of 1928 females with palpable breast lumps. FNA was done using a 23-gauge needle and results were interpreted by pathologists for adequacy and cellularity. Final cytological diagnoses were categorized as per United Kingdom National Health Services Breast Screening Program (NHSBSP) guidelines. The benign and malignant categories were correlated with risk factors like Age, Obesity, Genetic factors/ family history, contraceptives use, menstrual history, etc. All the collected information was analyzed using SPSS version-24. Frequency and percentages were measured for variables like FNAC categories and age. Risk factors were compared with benign and malignant categories and Chi-square test was used for correlation. Results: Out of 1928 cases, 469 (24.3%) were C5 (Malignant), and 1234 (64%) were C2 (Benign).  For practical and treatment purposes both C2 and C3 were considered benign, comprising of 1357 (70.4%) cases and C4 and C5 were taken as malignant comprising of 571 cases (29.6%). Correlation of risk factors with Breast cancer revealed that following parameters were significant with P valve <0.05; Age 40-100 years, Obesity, Breast feeding, Active smoking, Married couple, Post menopause, Contraceptives not used and Malignant tumor history. On the other hand, Family history and radiation exposure were not found significant in the current study. Conclusion: Age ˃ 40, obesity, active smoking, post-menopausal status, breast feeding, marital status and malignant tumor history are the significant risk factors which are associated with breast FNAC categories of C4 and C5.