Cytohistopathological correlation of C3 and C4 breast lesions.

Abstract

To conduct an audit of smears in cytological categories C3 and C4 of fine-needle aspirates from breast lesions in comparison with histopathological diagnoses. Comparative, cross-sectional study. Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from January to December 2002. Out of all patients referred to AFIP, Rawalpindi for aspiration of breast masses, those adjudged C3 and C4 were chosen for this study. History, clinical details and mammographic findings were noted. Aspirated smears were stained with haematoxylin and eosin as well as a Romanovsky dye. On excision or incision biopsy of these lesions, the cytological findings were compared with those on paraffin-embedded histological sections. The total number of patients in these two categories was 54. Surgical specimens of 3 cases were found inadequate for assessment. Of the remaining 51 cases, 13 were categorised C3 and 38 C4. Sensitivity of 92%, specificity of 83% and accuracy of 90% were attained. Positive and negative predictive values were 95% and 77% respectively. Categories C3 and C4 are areas where the cytopathologist is in doubt as to the benign or malignant nature of a breast mass. High sensitivity, positive predictive value and accuracy, being the hallmarks of a good screening procedure, underscore the validity of the technique.