FNA IN DIAGNOSIS OF BREAST TUMOR

In the process of establishing a diagnosis of breast tumors we know the term triple diagnosis, the components of which consist of clinical, radiological and pathological diagnoses. If it fulfills two of the three components, or all of the three components, it will be used as a work diagnosis for further patient management. The clinical diagnosis is made based on the history and physical examination carried out by the clinical doctor. Radiological diagnosis is made based on radiological examination such as ultrasound, mammography, MRI, etc. Pathological diagnosis is made on the basis of cytopathological or histopathological examination. One of cytopathological examination is the Fine needle aspiration (FNA) examination.

Fine needle aspiration is a pathology examination method where the cytological specimen examined is obtained by performing puncture and aspiration with fine needles (needle caliber G23 to G27). Puncture can be done without ultrasound guidance for clearly localized tumors or puncture without ultrasound guidance for tumors that are not clearly localized. Repeated puncture can be done several times until enough specimens are obtained for diagnosis. For cystic tumors, cystic fluid can be aspirated, which is then processed into cytological preparations. The diagnosis is made by evaluating cells under a microscope. The FNA technique is quite simple and the equipment needed is also simple. At present, the FNA technique can be performed by general practitioners or surgeons, radiologists and pathologist. After a smear is made from the specimens obtained, the smear can be sent to the laboratory for cytopathology examination.

Cytological diagnoses in the breast are categorized into 5 namely C1 to C5. C1 (unsatisfactory) is a case with inadequate to make a diagnosis. C2 (benign) is a benign tumor. C3 (probably benign) that is the case tends to be benign. C4 (probably malignant), which is a case that tends to be malignant. C5 (malignant) is a malignant case. After a cytological diagnosis is obtained, based on the concept of a triple diagnosis, patient management will then be determined. For definitive diagnosis will be established based on histopathological examination of biopsy or surgery specimens.