“A Study of Tru-Cut Biopsy and Fnac in a Clinically Palpable Breast Lump"
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 1
Abstract
Background: Breast i s host to many di seases which range f rom benign and mal ignant n e o p l a s m ’ s , i n f l a m m a t o r y c o n d i t i o n s t o i n f e c t i o n s , m o s t o f w h i c h p r e s e n t a s l u m p s i n t h e b r e a s t . B r e a s t l u m p s a r e o n e o f t h e c o m m o n e s t c o m p l a i n s e n c o u n t e r e d i n s u r g i c a l O P D ’ s which makes i t important to di f ferent iate between benign and mal ignant condi t ions before treat ing i t . The succes sful diagnosi s of the di sease i s based on a thorough under standing of normal anatomy, phys iologic and pathologic features of the breas t . Succes s in surgical management of pat ient can be convenient ly divided into three phases Pre, int ra and post operat ive. Vi tal ly important i s the preoperat ive deci sion making and planning. An exper t ly per formed operat ion for a wrong reason i s s t i l l a bad operat ion . The foundat ion of thi s succes s i s thorough knowledge of surgical anatomy and pathology. Var ious diagnost ic methods have been developed to evaluate the breast lumps wi th the goal of ident i fying a sensi t ive, speci f ic, ef f icient and economical approach to d iagnose breast cancer. Phys ical examinat ion, mammography, Tru -cut biopsy (Core needle biopsy) , ul t rasonography, thermography, FNAC open exci sion biopsy are al l used to greater or lesser extent in diagnost ic workup of a palpable breas t mas s. Various combina t ions of these approaches have been studied and have been found to increase the speci f ici ty and sensi t ivi ty over that of any one test alone. Fine Needle Aspi rat ion Cytology has been proved to be of great value in the diagnos is of breast lumps, apart f rom b eing cos t ef fect ive, i t i s al so simple and quick whi le providing the cytological diagnosi s. FNAC i s of ten used as a f i r st priori ty inves t igat ion in pat ient s wi th breast lump. zobtaining hi stopathological diagnosi s. I t i s relat ively easy and can be per formed on an outpat ient bas is . I t al so avoids unnecessary exci sional biopsy. Thi s s tudy i s aimed to f ind out the sensi t ivi ty and speci f ici ty of FNAC and Tru -cut biopsy wi th respect to cl inical ly palpable brea s t lumps by compar ing i t wi th the hi sto - pathological (gros s specimen) repor t s. Aims and Object ives of the s tudy. 1. To f ind the sensi t ivi ty and speci f ici ty of FNAC and Tru -cut biopsy 2. To s tudy the ef f icacy of FNAC and Tru - cut biopsy wi th that of Hi stopathological (gross specimen) s tudy in diagnos ing a breas t lump. 3. To f ind l imi tat ions of FNAC and Tru -cut biopsy. Mater ial and methods: A total number of 30 FNAC and 30 Tru -cut biops ies of breas t col lected f rom July 2014 to June 2016 at KSHEMA Hospi tal , Mangalore. Results: We had accuracy rate of 86.4% for FNAC, 96.3% for True-Cut biopsy and combined accuracy of 100%. The overall sensitivity of FNAC is 76.8% and that of True cut biopsy is 90%in our study. The overall specificity of FNAC is 100% and that of True cut biopsy is 100% in our study. The overall sensitivity of FNAC and true cut biopsy combined is 100 % in our study. The overall specificity of FNAC and True cut biopsy combined is 100% in our study Conclusion: Both FNAC and True cut biopsy are important tool in management of patients with breast lump. When performed by expert hands ,the diagnostic accuracy of both is very high but not 100%.when combined together accuracy is 100%. Thus we have no hesitation that FNAC and True cut biopsy is a very preliminary diagnostic test in clinically palpable breast lumps, the results show 100% co relation with postoperative histopathology report when “A Study of Tru-Cut Biopsy and Fnac in a Clinically Palpable Breast Lump" DOI: 10.9790/0853-1601030511 www.iosrjournals.org 6 | Page combined together .so it can be advised that the patients who have undergone both the above preliminary diagnostic procedures can be directly managed with definitive therapy.
Authors and Affiliations
Ganesh Gojanur, Lancelot Lobo, Nakul Mahesh Babu, Adithya G
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