The Role of DPAS in Improve the Efficacy of FNA in Detection of Breast Lumps.

Abstract

Background:Fine-Needle Aspiration (FNA) has become an essential, critical preoperative and screening test for breast masses. ObjectivesThis study aimed to evaluate the role of Diastase-Resistant Periodic Acid Schiff (DPAS) in improving the efficacy of FNA in the detection of cytological changes in breast lumps.Methods:This prospective cross-sectional study carried out in Khartoum state (Sudan), among Sudanese women who suffered from breast lumps. FNA samples were collected from each patient, and the material was simultaneously smeared onto two labeled glass slides..DPAS score and AC grade were expressed as mean±SD, and the 95% confidence intervals (CIs) of the means were calculated. Results: The findings revealed that the DPAS scores were found as follows; negative (±) 28(13.9%), one plus (+) 114(56.7%), two plus (++) 27(13.4%) and three-plus (+++) 32(15.9%).The analysis of DPAS scores versus the cytological categories (cytology results) revealed that DPAS positivity (++, +++) correlated best with malignancy. Out of the two hundred and one patient's Aspiration cytology (AC) grades among studied women according to the International Academy of Cytology (IAC) system were found as follows; AC2 30(14.9%), AC3 112(55.7%), AC4 27(13.4%) and AC5 32(15.9%).Eleven cases were upgraded from suspicious of malignancy in AC4 to malignant on AC5. On the others hand, there was a statistically significant association between aspiration cytology grades and cytology results, malignant findings significantly associated with AC grade 5.Conclusions:DPAS positivity within atypical cells in FNA aspirates may assist in upgrading from a suspicious to a malignant diagnostic result.