Fine needle aspiration of breast lumps -Diagnostic pitfalls
Journal Title: Medpulse International Journal of Pathology - Year 2018, Vol 8, Issue 2
Abstract
Background: Breast lesions are one of the most frequently encountered lesions in females. Fine Needle Aspiration Cytology (FNAC) has played an important role in early diagnosis of breast masses. The main objective of FNAC is pre-operative detection of cancer to avoid unnecessary surgery in benign conditions. Aims and Objectives: To examine the sensitivity, specificity and diagnostic accuracy of FNAC of breast lumps by cytohistopathological correlation. To identify discrepancies in FNAC that lead to false diagnosis. Materials and methods: This is a retrospective study carried out in a tertiary care hospital. Three hundred and sixteen FNAC cases over a period of two years were reviewed to identify cytological characteristics. Of the 316 breast lump FNACs, 74 cases had histopathological correlation available. Cytological findings were correlated with histopathological findings following which the concordance and discordance were analysed. The sensitivity, specificity and diagnostic accuracy of FNAC were evaluated. Results: Benign proliferative breast disease (BPBD) was the most common benign lesion and invasive ductal carcinoma was the most common malignant lesion cytologically. Out of the total 316 FNACs histopathological correlation was available in 74 cases, of which 39.2% of the cases were confirmed as benign and 60.8% of the cases were malignant. Histopathologically, the most common benign lesion was fibroadenoma and the most common malignant lesion was invasive ductal carcinoma. In the present study discordance in cyto-histopathological correlation was observed in 8 cases. The sensitivity, specificity and diagnostic accuracy was 88.7%, 100% and 89% respectively. Conclusion: FNAC of breast lesions has a good sensitivity and specificity in detecting malignancies. Hence, it should be done before an invasive surgical approach, though histopathology is the gold standard in evaluation of breast lesions. FNAC is a reliable tool to distinguish benign and malignant breast lesions.
Authors and Affiliations
Sushma Hosamane, Vishwanath Meghashree
Keywords
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