CYTOLOGIC OUTCOME OF BREAST MASSES IN PATIENTS ATTENDING FINE NEEDLE ASPIRATION CLINIC AT MOI TEACHING AND REFERRAL HOSPITAL, KENYA

BACKGROUND

Breast conditions can be divided into neoplastic and non-neoplastic. The conditions affect both men and women of all ages. Fine needle aspiration is indicated when a patient presents with a palpable breast lump or sometimes mammograph-detected lumps. Despite the breast cancer awareness programs, many people do not attend breast cancer screening clinics early enough. Majority of breast cancer patients present to the clinicians when the breast cancer is at an advanced stage. Risk factors for breast cancer include alcohol abuse, smoking, age and gender. This study aimed to determine the cytologic outcome of breast masses in patients attending fine needle aspiration clinic at Moi Teaching and Referral Hospital, in Eldoret, Kenya.

METHOD

This was a cross sectional study. A total of 150 patients (146 female and 4 male) were be recruited by purposive sampling. Fine needle aspirates of their breast masses were obtained. Axillary lymph nodes were also sampled as indicated. Smears were prepared, fixed immediately in 95% ethanol for at least 15 minutes and stained by the Papanicolaou staining protocol. The preparations were examined microscopically and reported by the technologist and reviewed by the attending pathologist. Secondary data was obtained from pathologists’ laboratory reports. Descriptive statistics of mean and mode based on age and gender were analyzed using SPSS version 22 statistical software. The results were then presented in the form of charts and tables.

RESULTS

The study revealed that fibroadenoma was the most common cytologic finding (46.8%) followed by Ductal carcinoma (9.3%). Among the 12-25 years age bracket fibroadenoma comprised 33.3% of that population but the percentage decreased with increasing age. The least occurring findings in this age bracket were ductal papilloma (0..6%) and lipoma (0.6%). In the 26-39 years age bracket, fibroadenomas were also a common finding (9.3%) followed by fibrocystic changes of the breast (6%). Among the male patients, gynecomastia was the common cytologic finding (2.6%). All ductal cell carcinoma cases were detected in women above 40 years of age with 3.9% of the them showing metastasis to axillary lymph nodes.

CONCLUSION

A young age is associated with a reduced incidence of breast cancers however there is a marked rise in breast neoplasms with advancing age. Gynecomastia is a rapidly rising finding in men probably due to environmental and hormonal factors.