Assessment of Diagnostic Accuracy of Fine Needle Aspiration Cytology in the Benign and Malignant Palpable Breast Lesions and its Concordance with the Histopathological Correlation in Regards to the Age, Sex, Locus and Circumstances

Objectives: To evaluate the diagnostic accuracy of Fine needle aspiration cytology (FNAC) of breast and to ascertain the use of Fine needle aspiration cytology to differentiate the benign and malignant lesion of the breast and its correlation with histopathological examination with regards to their age, sex, locus and circumstances.
Study Design: The present study was done ambispectively and it was conducted in the Department of pathology, 600 bedded capacity tertiary care referral hospital located at Mangalore, Karnataka, India from the duration of January 2015 to March 2017 presenting with complaints of breast lesions. The parameters included in the study were age group, location, duration of lesion and associated regional lymphadenopathy. In this study we included 200 patients whose Fine needle aspiration cytology materials was available. Out of these 200 patients, in 54 Patients surgical material was accessible, cyto-histological correlation was done in those patients.
Results: Out of 200 cases of Fine needle aspiration cytology of breast lumps, 160 cases were diagnosed as benign breast lesions, 34 cases were diagnosed as malignant breast lesions, 4 cases were reported as unsatisfactory and the remaining two cases were interpreted as suspicious on cytology. In a total these 200 cases, 54 cases histological examination was carried out. Among these 54 cases 30 were diagnosed as benign breast lesion, 22 cases were interpreted as malignant breast lesion, and the remaining 2 cases were reported as unsatisfactory and suspicious of malignancy on cytology but on histological examination of these 54 cases, 32 were confirmed as benign breast lesions and the other 22 cases were confirmed as malignant breast lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 90.9%,93.75%,90.9%,93.75% and 92.6% respectively.
Conclusion: In conclusion, Fine needle aspiration cytology of breast lesions has limitations in accuracy. But it has its own circumstances such as rapidity, simplicity and noninvasiveness. It should not be used as the sole diagnostic modality in palpable breast lesions due to false negative and false positive diagnosis. Better it should be combined with other clinical and radiological diagnostic modalities such as physical examination, ultrasonography and mammography.