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Fibroadenoma, FNAC sensitivity, breast carcinoma, breast one stop clinic
Background: The role of the breast clinics is to diagnose breast cancer and reassure patients with benign disorders. One stop clinics - same day reporting - further reduce anxiety caused by the delay in the results. The first one stop clinic was introduced in SQUH–Oman in September 2011.
Methods: This retrospective analysis of 395 consecutive cases presented to Breast One Stop Clinic at SQUH was done between September 2011 and December 2013. All patients underwent triple assessment conducted by consultants. Mammography was performed for patients above 35 years with no contraindications. Ultrasound was done for all patients with palpable lesions. The reports were assigned a score (BIRADS 0-6). Fine Needle Aspiration Cytology (FNAC) was done for all patients with palpable abnormality or nipple discharge. An immediate report was given using the standard reporting categories: acellular/inadequate, benign, atypical, suspicious, and malignant (C1-C5).
Results: Out of 395 patients, 210 were found to have palpable lesions with a mean age of 36 years (12-84 years). All patients were female. The FNAC sensitivity and specificity was 95.7% and 92.2%, respectively. Out of 210 patients, 15.3% were diagnosed with breast cancer on FNAC who were subsequently staged and discussed in the Breast Multidisciplinary Team Meeting (MDT), and 84.7% were diagnosed to have benign breast disorders who were reassured and advised to be followed up after 6 months.
Conclusions: Immediate relief and reassurance to the majority of patients with benign disease obviate the need for review appointments. A reliable diagnosis can be obtained with triple assessment which can be used to avoid unnecessary core biopsy of benign lesions, if correctly done.