Original Article: Diagnostic Accuracy of Ultrasound-Guided FNAC in Carcinoma Breast Patient Taking Histopathology as a Gold Standard

Abstract

Background: Ultrasound is a sensitive tool for detecting axillary metastasis in breast cancer patients in the absence of palpable lymph nodes. FNA (Fine Needle Aspiration) of these suspicious nodes can help in accurate preoperative staging of the axilla. Materials and Methods: This descriptive cross-sectional study was conducted at Department of Surgery, Unit 1 at Holy Family Hospital, Rawalpindi from 20th February 2017 to 19th August 2017. A total number of 100 patient of biopsy-proven breast cancer with no palpable lymph nodes in axilla were included. All underwent axillary ultrasound. FNA was performed in all cases having suspicious lymph node characteristics. Those having malignant cells in FNA report had axillary dissection without undergoing per-operative sentinel lymph node biopsies. In rest, per-operative SLNB (Sentinel Lymph Node Biopsy) was performed. Postoperative all dissected axillary specimens were reviewed by a pathologist for final diagnosis. Results: Ultrasonography guided FNA supported the diagnosis of malignant breast lesions in 60 (60.0%) patients. Histopathology confirmed malignancy in 62 (62.0%) cases. In 60 ultrasonography-guided FNA positive patients, 58 (true positive) had malignant breast lesions and 02 (false positive) had benign on histopathology findings. Among, 40 ultrasonography-guided FNA negative patients, 04 (false negative) had malignant breast lesions on histopathology whereas 36 (true negative) had benign lesions on histopathology. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound-guided FNA for diagnosis of carcinoma breast taking histopathology as the gold standard was 93.55%, 94.74%, 96.67%, 90.0% and 94.0% respectively Background: Ultrasound is a sensitive tool for detecting axillary metastasis in breast cancer patients in the absence of palpable lymph nodes. FNA (Fine Needle Aspiration) of these suspicious nodes can help in accurate preoperative staging of the axilla. Materials and Methods: This descriptive cross-sectional study was conducted at Department of Surgery, Unit 1 at Holy Family Hospital, Rawalpindi from 20th February 2017 to 19th August 2017. A total number of 100 patient of biopsy-proven breast cancer with no palpable lymph nodes in axilla were included. All underwent axillary ultrasound. FNA was performed in all cases having suspicious lymph node characteristics. Those having malignant cells in FNA report had axillary dissection without undergoing per-operative sentinel lymph node biopsies. In rest, per-operative SLNB (Sentinel Lymph Node Biopsy) was performed. Postoperative all dissected axillary specimens were reviewed by a pathologist for final diagnosis. Results: Ultrasonography guided FNA supported the diagnosis of malignant breast lesions in 60 (60.0%) patients. Histopathology confirmed malignancy in 62 (62.0%) cases. In 60 ultrasonography-guided FNA positive patients, 58 (true positive) had malignant breast lesions and 02 (false positive) had benign on histopathology findings. Among, 40 ultrasonography-guided FNA negative patients, 04 (false negative) had malignant breast lesions on histopathology whereas 36 (true negative) had benign lesions on histopathology. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound-guided FNA for diagnosis of carcinoma breast taking histopathology as the gold standard was 93.55%, 94.74%, 96.67%, 90.0% and 94.0% respectively.