Reasons for Failure of Physical Examination in Breast Cancer Detection (Analysis of 232 False-Negative Cases)

1983 ◽  
Vol 69 (6) ◽  
pp. 531-537 ◽  
Author(s):  
Gaetano Cardona ◽  
Luigi Cataliotti ◽  
Stefano Ciatto ◽  
Marco Rosselli Del Turco
Keyword(s):  
Breast Cancer ◽  
Physical Examination ◽  
False Negative ◽  
Needle Aspiration ◽  
Diagnostic Methods ◽  
Lower Sensitivity ◽  
Younger Women ◽  
Detection Analysis ◽  
Diagnostic Role ◽  
Needle Aspiration Cytology

The diagnostic role of physical examination (PE) is evaluated in 1450 cases of breast cancer detected in 34,677 women controlled at the Centro per lo Studio e la Prevenzione Oncologica in the period 1974–1981. In 47 cancer cases, PE findings were normal since the neoplasm was not clinically palpable because of its size and site, and in another 185 cases the clinical diagnosis was benignancy without evidence of suspect signs. Therefore, the overall sensitivity of PE was 84%. PE errors did not involve a therapeutic delay for the patient in 75% of cases in which a biopsy was recommended for clinical benignancy or for suspicion on the basis of other diagnostic methods. The present study confirms that PE has a good diagnostic sensitivity when the examined population is represented by self-referred women, who for the most part are symptomatic, whereas it cannot be considered as the only diagnostic test for early diagnosis in mass screening, since in asymptomatic women a large number of cancers are not clinically palpable. Moreover, PE shows lower sensitivity for small lesions and in younger women. Extensive use of fine needle aspiration cytology and other diagnostic methods in association with PE is therefore recommended to reduce the possibility of errors.

Accuracy of Breast Cancer Diagnosis by Physical, Radiologic and Cytologic Combined Examinations

1983 ◽  
Vol 69 (2) ◽  
pp. 137-141 ◽  
Author(s):  
Alberto Azzarelli ◽  
Adalgiso Guzzon ◽  
Silvana Pilotti ◽  
Vittorio Quagliuolo ◽  
Aldo Bono ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Examination ◽  
Breast Cancer Diagnosis ◽  
Needle Aspiration ◽  
High Rate ◽  
Aspiration Cytology ◽  
Female Breast ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity ◽  
Short Time

Physical examination, mammography and fine-needle aspiration cytology were performed in 1498 consecutive cases with a solitary solid lump of the female breast. The intent was to verify the validity of this diagnostic triplet in the accuracy of the preoperative diagnosis of breast cancer. Clinically sure cancers were excluded from the study. The collected data were evaluated in terms of sensitivity, specificity and predictivity of any procedure alone or in combination. In 1138 cases confirmed by histology (514 carcinomas and 669 benign or non-neoplastic lesions), the physical examination and mammography were very sensitive (respectively 96% and 84%) but with a high rate of false-positive reports (respectively 20% and 18%). The cytologic diagnosis was less sensitive (65%), mostly due to many inadequate smears, but highly specific (93%) and predictive for malignancy (99%) when the cytologic report was frankly positive. Any single procedure improved the overall sensitivity, and taken together this triplet appears to be the most effective noninvasive diagnostic combination that provides in a short time with minimal cost and discomfort, a diagnosis of certain malignancy in about 50% of carcinomas with a predictivity close to 100%, when cytology detected malignancy.

Breast Cancer Diagnosis under the Age of Forty Years

1987 ◽  
Vol 73 (5) ◽  
pp. 457-461 ◽  
Author(s):  
Stefano Ciatto ◽  
Andrea Herd Smith ◽  
Cosimo Di Maggio ◽  
Luigi Pescarini ◽  
Enzo Lattanzio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
False Negative ◽  
Breast Cancer Diagnosis ◽  
Needle Aspiration ◽  
High Rate ◽  
Consecutive Series ◽  
Benign Lesions ◽  
Aspiration Cytology ◽  
Needle Aspiration Cytology

The authors report on a multicentric consecutive series of 382 cases of primary breast cancer detected before the age of 40 years. Physical examination (PE) was always performed, whereas other diagnostic tests were performed in selected cases, namely mammography (M) in 334, fine needle aspiration cytology (CYT) in 188 and thermography (TH) in 123 cases. Single tests showed a high rate of false-negative/benign cases (PE, 0.23; M, 0.26; CYT, 0.37 and TH, 0.50), especially when the T1 subgroup was considered (PE, 0.34; M, 0.38; CYT, 0.42 and TH, 0.78). The poor results recorded for TH make its current diagnostic use highly questionable. The policy of extensive biopsy of all « dubious » benign lesions on PE allowed for the detection of 41 of 382 cancers and reduced the PE false-negative/benign rate to 0.12 for the total or 0.15 for T1 cancers, although about 80 unnecessary biopsies for each cancer detected were performed in this way. The association of PE to one or more tests resulted in even lower false-negative rates (0.06 for the total, 0.10 for T1 cancers). The authors criticize the aggressive policy of extensive biopsy recommendation based only on a dubious report on PE alone and stress the opportunity of the routine association of M and CYT to PE, since this combination seems to achieve a higher breast cancer detection rate even in this age group.

scholarly journals Diagnostic Role of Fine Needle Aspiration Cytology in the Breast Lump With its Correlation with Histopathology

1970 ◽  
Vol 14 (2) ◽  
pp. 65-69
Author(s):  
Hazara Khatun ◽  
Suraiya Enam ◽  
Maleeha Hussain ◽  
Monowara Begum
Keyword(s):  
False Negative ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Breast Lump ◽  
Medical College ◽  
False Positive Diagnosis ◽  
Diagnostic Role ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

This study was carried out to evaluate the accuracy of FNAC and its role in palpable breast lumps for the early surgical management in outdoor and indoor patients of Dhaka Medical College during the period of January to December 2000. FNAC was performed on 310 patients who presented with palpable breast lumps. Histopathology was available in 122 cases, among which cytologically diagnosed benign cases were 106 proved so histologically in 105 (99.05%) cases but catagorized correctly in 99 cases. There was false negative diagnosis in one case. All 14 cases diagnosed as malignant in cytological examination were confirmed as such histologically. Two cases reported as suspicious for malignancy in cytological diagnosis, was proved malignant histologically. False positive diagnosis was made in one case. The accuracy of FNAC in the diagnosis of breast lump is quite satisfactory and can be compared with histopathological diagnosis. DOI: http://dx.doi.org/10.3329/taj.v14i2.8388 TAJ 2001; 14(2): 65-69

The Diagnostic Efficacy of Mammography and Palpation in Early Detection of Breast Cancer

1980 ◽  
Vol 66 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Marco Rosselli Del Turco ◽  
Gianfranco Giannardi ◽  
Natale Villari
Keyword(s):  
Breast Cancer ◽  
Early Detection ◽  
Physical Examination ◽  
Mass Screening ◽  
Screening Program ◽  
False Negative ◽  
Lower Percentage ◽  
Age Group ◽  
Diagnostic Efficacy ◽  
Younger Women

The diagnostic efficacy of mammography and physical examination, separately and considered together, are evaluated in 912 cases of breast cancer detected at the Center for Social Diseases of the Florence District, where there is a mass-screening program (110 cases) and a diagnostic service for self-referred women (810 cases). The overall sensitivity of the 2 methods increases with age; the trends of diagnostic efficacies of mammography and palpation according to age are similar, except in the 40–44 year age group, in which physical examination has a lower percentage of false-negative cases. In the screening group, there is a greater proportion of nonpalpable cancers and mammography has a larger diagnostic efficacy except in the 40–44 year age group. These results agree with the better sensitivity of mammography in smaller lesion (T1) and with the larger proportion of non-interpretable mammographies in younger women, because of the density of mammalian glands.

Role of fine needle aspiration cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm

2014 ◽  
Vol 19 (2) ◽  
pp. 110-118
Author(s):  
Mohammad Amzad Hossain ◽  
Md Zahedul Alam ◽  
Md Rojibul Haque ◽  
Md Nazmul Haque ◽  
KM Nurul Alam ◽  
...  
Keyword(s):  
Submandibular Gland ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Medical College ◽  
Preoperative Diagnostic ◽  
Needle Aspiration Cytology

Objective: To evaluate the role of Fine Needle Aspiration Cytology in the preoperative diagnosis of malignancy in parotid and submandibular gland neoplasm. Methods: This cross sectional study on 50 cases was conducted in the Department of Otolaryngology and Head-Neck Surgery of Sir Salimullah Medical College Mitford Hospital and Dhaka Medical College Hospital from January’2009 to June 2010. Results: Fine needle aspiration cytology findings of our all 50 cases were compared with postoperative histopathological reports. Out of the 50 cases, in 36(72%) cases of benign neoplasm and 7(14%) cases of malignant neoplasm, pre-operative FNAC findings and post operative histopathological findings were same. In 7 cases, FNAC and post operative histopathological findings did not matched. These were 2 (4%) false positive and 5 (10%) false negative result.In our study sensitivity of FNAC for reporting malignancy was 58.33%, specificity to rule out malignancy was 94.73% and overall accuracy in detecting malignant tumour was 86%. Positive predictive value and negative value were 77.77% and 87.80% respectively. It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Conclusion: FNAC is a useful preoperative diagnostic tool for malignant parotid and submandibular glands with high specificity and sensitivity. DOI: http://dx.doi.org/10.3329/bjo.v19i2.17634 Bangladesh J Otorhinolaryngol 2013; 19(2): 110-118

Effectiveness of the Pattern-Based Approach in the Cytodiagnosis of Salivary Gland Lesions

2016 ◽  
Vol 60 (2) ◽  
pp. 107-117 ◽  
Author(s):  
K. Amita ◽  
S. Vijay Shankar ◽  
M. Sanjay ◽  
B.M. Sarvesh
Keyword(s):  
Salivary Gland ◽  
False Negative ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Cytological Diagnosis ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Prior Informed Consent ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Objective: The aim of this study is to investigate, primarily, the effectiveness of the application of pattern-based analysis in the diagnosis of salivary gland (SG) lesions. Secondarily, an attempt was made to study the cytomorphology of the various lesions in detail and discuss the pitfalls and solutions involved in the challenging conditions at cytology. Materials and Methods: This was a prospective, cross-sectional study. All SG lesions over 2 years were subjected to fine-needle aspiration cytology with patients' prior informed consent. The lesions were classified based on the predominant pattern, and a provisional diagnosis was made. The secondary pattern and other features, such as background, were then taken note of, and a combined cytological diagnosis was rendered. The entire spectrum of lesions was divided into 6 morphological categories. Results: We had a total of 72 SG lesions. The most commonly affected gland was the parotid gland in 79.16% (57/72) of the cases. Surgery was performed in 26 cases (36.11%). A concordant diagnosis was obtained in 22 cases. The sensitivity, specificity and diagnostic accuracy by the pattern-based approach was 75, 100 and 88.46%, respectively. There were no false-positive cases, but 2 false-negative cases were recorded. Conclusion: The precise cytological preoperative diagnosis of SG lesions is important for the management of patients. The pattern-based approach can be used routinely in the cytological diagnosis of SG lesions.

scholarly journals A case report of 29 year old male patient with breast carcinoma: diagnosed on fine needle aspiration cytology

2019 ◽  
Vol 8 (1) ◽  
pp. 375
Author(s):  
Komal Patel ◽  
Pallavi Chaudhri ◽  
Siddhi M. Patel
Keyword(s):  
Breast Cancer ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Needle Aspiration ◽  
Male Breast ◽  
Breast Cancers ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
The Mean ◽  
Needle Aspiration Cytology

Breast cancer has been considered a female dominated disease. Carcinoma of male breast is a rare disease representing 1% of all breast cancers and less than 1 % of all cancers in men. The mean age at presentation is mainly in sixties. We here present a case of male breast cancer presented at very young age of 29 years, diagnosed on fine needle aspiration which was confirmed later on histopathological examination.

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