Use of Fine-Needle Aspiration in the Evaluation of Breast Lumps

Mulazim Hussain Bukhari,Shaharyar Shaharyar,Shahid Jamal,Madiha Arshad,Shahid Bashir,Shahida Niazi,Irfan M Bakhshi

doi:10.4061/2011/689521

Abstract

Background. A study was designed to see the role of fine needle aspiration cytology (FNAC) in palpable breast lumps. Materials and Methods. Four hundred and twenty five (425) patients came to the Department of Pathology King Edward Medical University, Lahore in four years for FNAC of their palpable breast masses from June 2006 to June 2010. FNAC diagnosis was compared with histological diagnosis to see the accuracy of fine needle aspiration cytology for neoplastic lesions. Results. There were 271/425 benign, 120/425 malignant, and 32/425 suspicious smears. Inadequate samples were repeated twice or thrice, and the degree of success was improved with consecutive repeating approaches. The frequency of inadequacy declined from 86 to 18, and 2 for first, second and third attempts, respectively. The number of repeats increased the diagnostic accuracy of aspirates which is statistically significant (P = .000). Invasive ductal carcinoma was the most commonly reported lesion with maximum incidence in the 4th, 5th, and 6th decades followed by invasive lobular carcinoma and other malignant lesions. The sensitivity, specificity, accuracy, negative predictive value, and the positive predictive value of FNAC was 98%, 100%, 98%, 100%, and 97%, respectively. Conclusion. FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment serves as an important diagnostic modality.

Highlights

All breast lesions are not malignant, and all the benign lesions do not progress to cancer; the accuracy of diagnosis can be increased by a combination of preoperative tests
Cytopathologists agree that a number of parameters relate to the adequacy of an fine-needle aspiration (FNA) specimen, there is no concsensus on the role of epithelial cell quantitation in the determination of an adequate FNA
Core Biopsy or tru cut needle biopsy is not widely used because of its complications, interpretation, and time-consuming results; palpable breast lesions can be accurately diagnosed by triple test only (FNAC, physical examination and Mammography) [7]

Summary

Introduction

All breast lesions are not malignant, and all the benign lesions do not progress to cancer; the accuracy of diagnosis can be increased by a combination of preoperative tests (like physical examination, mammography, fine-needle aspiration cytology, and core needle biopsy). These modalities are more accurate, reliable, and acceptable when compared with a single adopted diagnostic procedure despite of having their own technical limitations [1, 2]. FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment serves as an important diagnostic modality

Methods

Discussion

Conclusion