Diagnostic accuracy of fine needle aspiration cytology in breast lesions in a tertiary care hospital - One year study
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2017, Vol 21, Issue 3
Abstract
Background: For many years, since its introduction by Ellis and Martin, FNAC has proved to be a reliable tool in the diagnosis of breast diseases. Especially in the context of rising incidence of malignant breast diseases in the modern era and its sequel of inclusion of breast cancer screening programmes, it has assumed paramount importance in distinction between benign and malignant breast lesions. The aim of present study is to assess the role of FNAC, in terms of accuracy(sensitivity and specificity) in distinguishing between benign and malignant breast diseases. Material and Methods: About 341 FNAC smears were studied over a period of 1 year.(between July 2015 to June 2016). Histopathological correlations were obtained for 222 cases. Hematoxylin and eosin stains were performed for all aspirates. Results: Of the 341 patients, 322 patients were females and 19 were females. 233 patients had benign lesions including inflammatory lesions(68.34%). Fibroadenoma(23.75%) was found to be the commonest lesion.80 cases had malignancy(23.46%).78(22.87%) cases had ductal carcinoma and 2 had medullary carcinoma(0.59%).Of the 222 cases in which histopathological correlations were obtained,one case of Atypical ductal hyperplasia,22 cases of “suspicious for malignancy” and all the 80 malignant category cases were confirmed to have malignancy by histopathology(total 103).Two cases in the,” suspicious for malignancy” category were confirmed to be gynaecomastia by histology. Of the 154 benign lesions, 117 cases were confirmed to be benign by histopathology. The sensitivity and specificity were 100% and 98.3% respectively. The positive predictive value(PPV) and negative predictive value (NPV) were 100% both. Conclusion: The high sensitivity of FNAC is due to inclusion of cases with atypia and suspicious cases in the frankly malignant category. But in cases of gynaecomastia FNAC may show a malignant picture with considerable atypia but in our study it proved to be benign by histopathology.(false positivity).
Authors and Affiliations
Vetriveeran Sakkaravarthi, Murali Prasath S R
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