title: Empirical accuracy of fine needle aspiration cytology (FNAC) for preoperative diagnoses of malignant breast lumps in hospitals with restricted health resources.
abstract: OBJECTIVE
  To reevaluate the additional diagnostic value of FNAC from patient profiles in the diagnosis of breast cancer among patients presenting with breast lumps.
  
  
  METHODS
  A database was reconstructed from routine follow-up data of patients with breast diseases. Predictive ability of the variables were presented with an area under a receiver operating characteristic (ROC) curve using the logistic model.
  
  
  RESULTS
  Age and size of breast lumps alone could predict malignancy with a ROC area of 0.85, (95% CI = 0.81-0.89). When FNAC was added into the logistic model in the presence of age and size of breast lumps, the ROC area increased to 0.95 (95% CI = 0.93-0.97) with statistical significance. Given the same FNAC classification codes, the probability of malignancy increased in older patients and in patients with larger breast lumps.
  
  
  CONCLUSIONS
  In developing countries where health resources are restricted, FNAC seems to be cost efficient. Continued use of the technique should be encouraged.
authors.affiliation: Division of Clinical Epidemiology and Medical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. jpatumanond@yahoo.com
authors.forename: J
authors.initials: J
authors.lastname: Patumanond
authors.forename: T
authors.initials: T
authors.lastname: Kayee
authors.forename: U
authors.initials: U
authors.lastname: Sukkasem
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D055815:Young Adult