Comparative study of fine-needle aspiration cytology and needle core biopsy in the diagnosis of breast lumps with histopathological correlation

Abstract

Introduction: Diseases of breast constitute a large proportion of cases in surgical practice and need to be differentiate between benign from malignant lesions prior to definite treatment. Aims and Objective: The aim is to determine the accuracy with the benign and malignant lesions can be differentiated by fine-needle aspiration cytology (FNAC) and needle core biopsy (NCB) and to correlate the findings of NCB with histopathological diagnosis. Materials and Methods: It is a prospective study for one and half years comprising of 104 patients of breast lumps who underwent FNAC, NCB, and surgical excision followed by histopathological examination. Data have been collected and analyzed regarding sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC and NCB in comparison with histopathology (HP). Results: Out of 104 patients, the most common age group is 41–50 years (35 cases, 33.7%). The most common HP diagnosis was infiltrating ductal carcinoma followed by ductal carcinoma in situ (50 cases and 12 cases, respectively). In our study, we found FNAC has sensitivity 94.3%, specificity 100%, PPV 100%, NPV 87.9%, diagnostic efficiency 95% while NCB has sensitivity 97.3%, specificity 100%, PPV 100%, NPV 81.8% and diagnostic accuracy 97.6% in diagnosing breast lumps. Conclusion: NCB is better in comparison to FNAC in diagnosing breast lumps. However, the role of FNAC cannot be ignored in our settings especially in the diagnosis of benign breast conditions. NCB should be considered as second-line method of investigation in case of any doubt to rule out missed diagnosis of breast carcinoma.