Cytomorphological Spectrum of breast lesions and Diagnostic utility of Fine needle aspiration Cytology

Abstract

Fine needle aspiration cytology (FNAC) was described and practiced by Martin and Ellis in 1930. It is a well-accepted procedure and is a valuable tool in the diagnosis and patient management of breast lesions. The sensitivity and specificity of FNAC as a diagnostic tool for palpable breast lumps are 65-99% and 96-100% respectively. Therefore, the study aimed to access the cytomorphological spectrum of breast lesions. The present study included thirty-seven consecutive female patients of palpable breast lesions who underwent fine needle aspiration cytology (FNAC). After obtaining a detailed history followed by clinical examination, the FNAC procedure was performed. All the slides were stained with Hematoxylin and Eosin (H & E). The stained smears were viewed under microscope and cytological findings were interpreted accordingly. The most common affected age group was 40-49 years with preponderance on right side. Considering the Cytomorphological spectrum, the most common lesion was Fibroadenoma followed by Ductal carcinoma, fibrocystic disease, acute suppurative inflammatory lesion, benign breast lesion, granulomatous mastitis and atypical ductal hyperplasia. The ductal carcinomas were more commonly seen in the age group of 40-49 years and Fibroadenoma were more common in age group of 20-29 years. Fine needle aspiration cytology of breast lesions is a valuable, cost effective, minimally invasive and a rapid investigation. Majority of the lesions in the younger age group are benign in nature and malignant in older age groups. Despite its high accuracy, some pitfalls may lead to confusion and misdiagnosis of breast lesions. Therefore, accuracy of diagnosis increases when aided with radiological investigations.