Advantages of the cell block technique over the FNAC and correlation with histopathology of most prevalent breast lesions in the community at the tertiary care center

Abstract

Breast lumps are a common cause of concern in both young and older women throughout the world. Fine needle aspiration of breast lesions is an important and widely practiced method of providing a preoperative diagnosis in women presenting with a lump in the breast. Cell blocks that are made from the aspirates help in preserving the architecture, and the nuclear morphology and help in preserving the material for immunohistochemical studies. The present study aims to highlight the role of FNAC and cell block in the diagnosis of breast lesions. This was a two-year prospective study of 72 patients presenting with palpable breast lesions referred for FNAC to the Department of Pathology JJMMC, Davangere from 1st July 2015 to 30th June 2017. After a detailed history, general physical & local examination, informed consent was taken and FNAC was performed under aseptic precautions. A part of the aspirate was fixed, then processed as cell blocks, and stained with H&E. Wherever lumpectomy or radical surgery was performed the histopathology was correlated with cytomorphological findings.: The present study showed a diagnostic accuracy of 85.71% in the FNAC diagnosis. The sensitivity and specificity of FNAC in diagnosing breast lesions were found to be 82.60% and 87.23%. PPV and NPV were 76% and 91.11% respectively. When cell blocks were used the diagnostic accuracy increased to 88.57%. Diagnosis by using cell block showed a sensitivity of 79% specificity of 93.47%, PPV of 86.36%, and NPV of 89.58%.: From the results of our study, it can be concluded that the accuracy of diagnosing breast lesions preoperatively can be increased when FNAC is combined with the cell blocks from the aspirates. The cell blocks also help to preserve the aspirated material for future reference and immunohistochemistry can also be applied for a more accurate diagnosis.