Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

  • Published : 2014.04.30


Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.


  1. Abdel-Hadi M, Abdel-Hamid GF, Abdel-Razek N, Fawzy RK (2010). Should fine-needle aspiration cytology be the first choice diagnostic modality for assessment of all nonpalpable breast lesions? The experience of a breast cancer screening center in Alexandria, Egypt. DiagnCytopathol, 38, 880-9.
  2. Ahmed HG, Ali AS, Almobarak AO (2009). Utility of fineneedle aspiration as a diagnostic technique in breast lumps. DiagnCytopathol, 37, 881-4.
  3. Ahmed HG, Ali AS, Almobarak AO (2010). Frequency of breast cancer among Sudanese patients with breast palpable lumps. Indian J Cancer, 47, 23-6.
  4. Alatise OI, Lawal OO, Olasode OO, Adesunkanmi ARK (2006). Breast fine needle aspiration cytology In a Nigerian Tertiary Hospital. East and Central Afr J Surg, 12, 126-32.
  5. Brancato B, Crocetti E, Bianchi S, et al (2012). Accuracy of needle biopsy of breast lesions visible on ultrasound: audit of fine needle versus core needle biopsy in 3233 consecutive samplings with ascertained outcomes. Breast, 21, 449-54.
  6. Cochrane RA, Singhal H, Monypenny IJ, et al (1997). Evaluation of general practitioner referrals to a specialist breast clinic according to the UK national guidelines. Euro J SurgOncol, 23, 198-201.
  7. Garg S, Mohan H, Bal A, Attri AK, Kochhar S (2007). A comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesions. Diagn Cytopathol, 35, 681-9.
  8. Hamad HMA (2006). Cancer i nitiatives in Sudan. Ann Oncol, 17, 32-6.
  9. Hemminki K, Mousavi SM, Sundquist J, Brandt A (2011). Does the breast cancer age at diagnosis differ by ethnicity? A study on immigrants to Sweden. Oncologist, 16, 146-54.
  10. Hukkinen K, Kivisaari L, Heikkilä PS, Von Smitten K, Leidenius M (2008). Unsuccessful preoperative biopsies, fine needle aspiration cytology or core needle biopsy, lead to increased costs in the diagnostic workup in breast cancer. Acta Oncol, 47, 1037-45.
  11. Jack RH, Davies EA, Moller H (2012). Breast cancer and age in black and white women in South East England. Int J Cancer, 130, 1227-9.
  12. Kadhel P, Multigner L (2014). Age at breast cancer diagnosis in populations of african and European ancestry. Breast J, 20, 180-4.
  13. Kochhar AK, Jindal U, Singh K (2013). Spectrum of cytological findings in fine needle aspiration cytology of breast lumps with histopathology correlation: experience in a tertiary care rural hospital in India. Asian Pac J Cancer Prev, 14, 7257-60.
  14. Kumle M (2008). Declining breast cancer incidence and decrease HRT use. Lancet, 372, 608-10.
  15. Nggada HA, Tahir MB, Musa AB, et al (2007). Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions: a five-review. Afr J Med Med Sci, 36, 295-8.
  16. Ogunniyi JO, Senbanjo RO, Ogunlusi ML (1989). Fine needle aspiration cytology in the assessment of breast lumps in Ibadan. Afr J Med Sci, 18, 151-4.
  17. Oluwole SF, Fadiran OA, Odesanmi WO (1987) Diseases of breast in Nigeria. Br J Surg Oncol, 13, 505-9.
  18. Saleh FM, Ansari NP, Alam O (2012). Comparison between fine needle aspiration cytology with histopathology to validate accurate diagnosis of palpable breast lump. Mymensingh Med J, 21, 450-5.
  19. Singh R, Anshu, Sharma SM, Gangane N (2012). Spectrum of male breast lesions diagnosed by fine needle aspiration cytology: a 5-year experience at a tertiary care rural hospital in central India. Diagn Cytopathol, 40, 113-7.
  20. Slaoui M, Razine R, Ibrahimi A, et al (2014). Breast cancer in Morocco: a literature review. Asian Pac J Cancer Prev, 15, 1067-74.
  21. Wang XW, Xiong YH, Zen XQ, Lin HB, Liu QY (2012). Diagnostic accuracy of ultrasonograph guided fine-needle aspiration cytologic in staging of axillary lymph node metastasis in breast cancer patients: a meta-analysis. Asian Pac J Cancer Prev, 13, 5517-23.

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