Cytological Screening of Breast Cancer Using Breast Fluids among Women in Shendi Town at River Nile State, Sudan

Abstract

Background: Breast cancer is common in Sudan and most patients are detected at later stages of the disease due to the lack of awareness and absence of early screening programs. The majority of breast cancers originate in the epithelium lining the milk ducts. It is believed that most breast canceras are slow growing and progress from precancerous cells, which have cellular and nuclear changes that can be identified microscopically. Aim: To cytological screening of breast cancer in breast fluid. Methods: This is a cross-sectional feasible study conducted in Shendi town, 200 samples of different breast fluids from asymptomatic women. (100 nipple aspiration fluid, 50 milk smear, 50 postpartum milk) have been collected and screened cytologically. Stained by pap stain. Results: After cytology screening of breast fluid in, milk 30/50(60%) of women were non-cell secretors and 20/50 (40%) of women were cell secretors. Cells that appeared among the secreting group were a few epithelial cells and immune cells. In postpartum milk all women 50/50 (100%) were cell secretors, abnormal cytomorphological changes were in 15/50 (30%) of them, and high secretion of immune cells 50/50 (100%) which found to statistically of significant value (0.000). NAF was not produced in 78/100. Among women who produced NAF22/100, women were produced NAF 6/22 (27.3% ) were not cell secretors (category 0), benign nonhyperplasic ductal epithelial cells (category 1) 6/22( 27.3%), benign hyperplasic ductal epithelial cells (Category II) 5/22( 22.7%), atypical ductal epithelial cell (category III) 3/22 (13.7%) atypia (Category IV) 2/22(9%). cytological atypia 21/25 (84%) appears among women more than 30 years old and there was a strong statistical of significant value P. value =(0.000). Also, risk factors (family history, contraceptive intake, and HPV) statistically have a significant correlation with cytological atypia among study group P. value = (0.036). In this study HPV infection, cytomorphological change (koilocyte) was detected in breast fluid 4/200 (2%). Conclusion: cytology of the breast is a simple, safe, rapid test that is acceptable to patients and showed the ability to detect benign and pre-neoplastic ductal epithelial cells from asymptomatic volunteers.