Comparison of the efficacy of three stains used for the detection of cytological changes in Sudanese females with breast lumps.

Abstract

Background: Fine Needle Aspiration (FNA) is an important diagnostic method for breast cancer; it is affected by the type of stain. Aim: To compare the efficacy of each of Papanicolaou (Pap), Haematoxylin and Eosin (H&E), and MayGrunwald Giemsa (MGG) stains in breast FNA samples. Settings and Design: We conducted a prospective study of a convenience sample of two hundred females with breast lumps, who attended the Radiation & Isotopes Center – Khartoum and some private cytology clinics in the City of Khartoum, Sudan. Material and Methods: FNA samples were collected from each patient and the material was simultaneously smeared onto three labeled glass slides. Dry smears were stained with MGG stain, and wet fixed smears were stained with Harris’s haematoxylin and eosin and Pap stain. Statistical analysis used: For the evaluation of the three stains, scores were given on four parameters including background of smears, overall staining pattern, cell morphology and nuclear staining. Quality index was calculated as the ratio of score achieved to maximum possible score. Results: From two-hundred triple smears, the Pap stain showed the best staining quality with a quality index of (0.87), H&E came next with a quality index of (0.81), and MGG came last with a quality index of (0.77). Comparison of the efficacy of three stains used for the detection of cytological changes in Sudanese females with breast lumps Alkhair Abd Almahmoud Idris, M.Sc 1 Muhammed Sidahmed Hussain, Ph.D 2 1 Centre for Science and Technology, Ahfad University for Women-Sudan. 2 School of Health Sciences, Ahfad University for Women-Sudan. Corresponding Author: Alkhair Abd Almahmoud Idris, Address: Ahfad University for Women, Omdurman, Sudan, P.O.Box:167, Omdurman, Sudan, Phone number: +249-924706310, E-Mail: address:alkhair20@hotmail.com Introduction: Fine Needle Aspiration (FNA) has become an important preoperative and screening test for breast masses 1. It is easy to perform, quickly and has a high degree of specificity and sensitivity 2. The increasing popularity of FNA as a primary diagnostic procedure has demonstrated the utilization and adaptability of other stains such as the Romanowsky stains and Haematoxylin and Eosin (H&E) stain with traditional papanicolaou (Pap) stain 3. The main goal of diagnostic cytology is the recognition of cells derived from malignant tissues. The interpretation of the smear is difficult, depends on the experience of the pathologist and the site of collection of fine needle aspirate. In Sudan, breast FNA has been used widely in recent years as a diagnostic tool for breast cancer, so the quality of stains plays a great role in interpretation. In order to obtain reliable results, this study aimed to compare the efficacy of each of Pap, H&E and May Grunwald Giemsa (MGG) stain in breast FNA samples.