Breast Fine Needle Aspiration Cytology Research Articles

Diagnostic significance of cytological features in breast fine needle aspiration cytology - An institutional study in mandya institute of medical sciences, Mandya

Introduction and Objective: Fine needle a spiration cytology has importance in the diagnosis of breast lesions in several clinical and hospital settings. A study was done to assess the role of fine needle aspiration cytology (FNAC) in breast lumps and diagnostic significance of cytological features in FNA for diagnosis of benign or malignant condition of breast lesions. Materials and Methods: The study comprised of breast cytology reports and slides recorded over a period from January 2018 to December 2018. Results: A total of 250 breast cytology reports were made over the period. Out of the 250 cases, 140(56%) were benign, 30(12%) cases were suspicious probably benign, 30(12%) cases were suspicious of malignany and 50(20%) were malignant. Conclusion: Fine-needle aspiration cytology is widely used in the diagnosis of breast cancer because it is an excellent, safe, and cost-effective diagnostic procedure. Keywords: Breast, Fine needle aspiration cytology, Benign breast lesions, Carcinoma.

IAC standardized reporting of breast fine-needle aspiration cytology, Yokohama 2016: A critical appraisal over a 2 year period.

Breast cytology is a significant component of the "Triple approach" for pre-operative diagnosis of breast lumps, the other two being clinical assessment and radiological imaging. The role of Fine needle aspiration cytology (FNAC) as a first line investigation in diagnosing breast lesions is well documented, however histopathology is the gold standard. Cyto-histopathological correlation is of great relevance and also increases precision.AIMS \& OBJECTIVES:The present study was conducted with the aim to categorize breast lesions according to the latest standardized reporting system proposed by International academy of cytologists (IAC) in 2016. Evaluation of diagnostic accuracy, sensitivity and specificity of FNAC in diagnosing breast lesions and cyto-histopathological correlation was planned. All FNAs of breast lesions over a period of 2 years were included in the study. The cases were grouped into five standardized categories proposed by the International academy of cytology: Category I (Insufficient material), Category II (Benign), Category III (Atypical, probably benign), Category IV (Suspicious, probably in situ or invasive) & Category V (Malignant) respectively. Specificity, sensitivity, diagnostic accuracy, negative and positive predictive value of FNAC were calculated and cyto-histopathological correlation assessed wherever possible. Out of 468 breast lesions reported on FNAC, the category wise distribution was - Category I, II, III, IV & V accounting for 23(4.9%), 342(73.07%), 7(1.5%), 11(2.35%) and 85(18.16%) respectively. Histopathology was performed in 331/468 cases with cyto histological concordance of 98.4% and a type agreement rate of 90.9%. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy was 98.90%, 99.16%, 97.82%, 99.58% and 99.09% respectively. FNAC is a simple, reliable, cost effective, first line diagnostic procedure for all breast lumps. In collaboration with physical examination and imaging studies (triple approach), FNAC is a highly sensitive diagnostic tool. Adopting a universally acceptable standardized reporting system for breast cytology can enhance the diagnostic accuracy of FNAC.

Concordance of breast fine needle aspiration cytology interpretation with subsequent surgical pathology: An 18-year review from a single sub-Saharan African institution.

There are many merits to fine needle aspiration cytology (FNAC) in evaluation of palpable breast lesions. We set out to determine the concordance of breast FNAC interpretation with subsequent surgical pathology in the resource-limited healthcare setting of rural Kenya. African Inland Church Kijabe Hospital electronic pathology files were retrospectively reviewed from 1/1999-9/2017. All breast FNAC cases and subsequent surgical pathology specimens were identified. FNAC interpretations were categorised according to the International Academy of Cytology Yokohama codes: insufficient; benign; atypical favour benign; suspicious favour malignant; and malignant. Surgical pathology results were categorised as benign or malignant. In total, 695 breast FNACs were identified. A total of 219 (31.5%) had subsequent surgical pathology. Average patient age was 39years (range 13-88); 95% were female. Nearly all (98%) lesions were palpable. FNAC interpretive categorisation was as follows: 20 (9%) insufficient, 103 (47%) benign, 16 (7%) atypical, 24 (11%) suspicious and 56 (26%) malignant. On histopathology, there were 141 (64%) benign cases and 78 (36%) malignancies (Table1). The sensitivity of FNAC for detecting malignancy was 85%; specificity was 75%. Positive and negative predictive values were 69% and 88%. Diagnostic concordance between FNAC and histopathology was 79%. For definitively diagnostic FNAC categories, diagnostic concordance was 89%. On histopathology, malignant diagnoses were given in 0 insufficient, 12 (12%) benign, 4 (25%) atypical, 11 (46%) suspicious and 51 (91%) malignant cases. There were five false-positive cytopathology interpretations and 12 false-negatives. FNAC remains a valuable tool in evaluation of palpable breast lesions in resource-limited healthcare settings.

Masood’s and Modified Masood’s Scoring Index: An Evaluation of Fine Needle Aspiration Cytology of Breast Lesions with Histopathological Correlation

Objective: As fine needle aspiration cytology (FNAC) is the primary tool for evaluation of breast lesions, it is essential to segregate lesions with low and high risk of malignancy. To address this, Masood proposed a cytological scoring system for categorization, Masood’s Scoring Index (MSI), which was modified later (Modified Masood’s Scoring Index [MMSI]). This study analyses the effectiveness of MMSI over MSI and assesses the concordance between cytological scoring and histopathology. Study Design: All breast FNACs over a period of 2 years were categorized based on MSI and MMSI by 2 reviewers independently. The agreement rate along with specificity, sensitivity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. Correlation and concordance analyses between cytological and histopathological categories were conducted. Results and Discussion: Out of 415 cases of breast FNACs, histopathology was available for 310 for which MSI and MMSI were evaluated. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 95, 100, 100, 97.6 and 98.3%, respectively. The difference between the concordance rate of MSI and of MMSI for various cytological categories was found to be statistically significant. Conclusion: MMSI has a better concordance with histopathological diagnosis than MSI. MMSI can serve as a uniform standardized scoring system for breast cytology for better categorization of proliferative breast diseases.

Comparative assessment of CNN architectures for classification of breast FNAC images

Fine needle aspiration cytology (FNAC) entails using a narrow gauge (25-22 G) needle to collect a sample of a lesion for microscopic examination. It allows a minimally invasive, rapid diagnosis of tissue but does not preserve its histological architecture. FNAC is commonly used for diagnosis of breast cancer, with traditional practice being based on the subjective visual assessment of the breast cytopathology cell samples under a microscope to evaluate the state of various cytological features. Therefore, there are many challenges in maintaining consistency and reproducibility of findings. However, the advent of digital imaging and computational aid in diagnosis can improve the diagnostic accuracy and reduce the effective workload of pathologists. This paper presents a comparison of various deep convolutional neural network (CNN) based fine-tuned transfer learned classification approach for the diagnosis of the cell samples. The proposed approach has been tested using VGG16, VGG19, ResNet-50 and GoogLeNet-V3 (aka Inception V3) architectures of CNN on an image dataset of 212 images (99 benign and 113 malignant), later augmented and cleansed to 2120 images (990 benign and 1130 malignant), where the network was trained using images of 80% cell samples and tested on the rest. This paper presents a comparative assessment of the models giving a new dimension to FNAC study where GoogLeNet-V3 (fine-tuned) achieved an accuracy of 96.25% which is highly satisfactory.

Usefulness of Cytological Scoring Method by Breast Fine Needle Aspiration Cytology on Breast Duct Dilatation and Cystic Lesions.

Aim:The objective of this study was to apply a scoring method to fine needle aspiration cytology on breast duct dilatation and cystic lesions, to set an optimum cut-off value to differentiate between benign and malignant cases, and to identify features useful for cell judgment.Materials and Methods:Samples were 23 preparations of specimens (12 benign and 11 malignant cases) suspected with intraductal lesions or cystic change by ultrasonography or mammography and cytology. The scoring system comprised the following 10 items, and each item was scored 1–3, with a total score of 10–30. Three items were concerning structural atypia: 1, scattered epithelial cells; 2, uneven irregular cluster edge; and 3, overlapping nuclei of epithelial cells, and seven items were concerning cellular atypia: 4, irregular nuclear size; 5, irregular nuclear morphology; 6, deep dyeing chromatin; 7, chromatin granularity; 8, chromatin distribution; 9, nucleolus; and 10, absence of myoepithelial cells.Results:(1) Scoring cut-off value: malignancy is to be suspected when the score is 20.75 or higher (diagnostic accuracy: 95.7%). (2) Findings useful for cancer judgment: the sensitivity of the following four findings was high: uneven irregular cluster edge, irregular nuclear overlapping, chromatin granularity, and absence of myoepithelial cells. (3) Correlation among the findings: the findings correlated with malignancy were as follows: scattered epithelial cells versus uneven irregular cluster edge (rs = 0.8).Conclusion:Cytological evaluation by scoring lesions accompanied by intraductal dilatation and cystic change was a useful method capable of differentiating between benign and malignant cases at a high accuracy.

Comparative Analysis of Liquid based and Conventional Cytology Smears in Fine Needle Aspirates from Breast Lesions.

Context:Liquid-based cytology (LBC) is being extensively used for the evaluation of both gynecological and non-gynecological specimens. Suspension of cells in monolayer makes better morphological assessment possible. Along with this, inherent morphological changes such as altered, reduced, or lost background material, fragmented cell clusters, smaller cell size, nucleolar prominence, etc., need to be considered.Aim:Present study was aimed at comparative evaluation of utility of LBC versus conventional smear (CS) in assessing breast lesions and whether it can be used as an alternative to conventional preparation.Settings and Design:Present study was a prospective study in which 75 cases of breast fine-needle aspiration cytology from patients with palpable breast lumps constituted the study group.Material and Methods:The first pass was used for CS and LBC; a second pass was given. The representative CS and LBC smears were compared using several criteria.Statistics:Each feature was scored individually and evaluated statistically using Wilcoxon's signed rank test on the SPSS program.Results:A statistically significant difference was found in informative background and background blood-debris, whereas the difference was not statistically significant in other features such as cellularity, cytoarchitectural pattern, presence of monolayer, and nuclear and cytoplasmic details.Conclusion:LBC is a promising technique in the field of cytology. It has the potential to decrease the number of slides screened per case and decrease the turn-around-time.

Expression of p63 immunostaining in liquid-based cytology (BD SurePath) of breast fine-needle aspiration.

We performed p63 immunostaining to detect myoepithelial cells on BD SurePath liquid-based cytology (LBC) slides and examined whether this improved the diagnostic accuracy in breast fine-needle aspiration cytology (FNAC). We examined the diagnostic accuracy using the LBC-p63 immunostaining slides of 298 lesions obtained from July 2010 to August 2016. We defined the cutoff values for malignancy as follows: (1) the percentage of p63+ cluster was <30%, (2) the percentage of p63+ single cells in cell clusters was <3%, (3) the number of p63+ single cells in the background was <20 when the total number of the cell clusters was <100, or the number was <120 when the total number was ≥100. The malignant lesions showed significantly lower values than the benign lesions in the percentage of p63+ clusters, the percentage of p63+ single cells in the clusters, and the number of p63+ single cells in the background (P < .001). The diagnostic values obtained only by Papanicolaou staining vs the improved values with LBC-p63 immunostaining slides were as follows. Sensitivity, 88.3% to 99.0%; specificity, 89.1% to 99.0%; positive predictive value, 94.8% to 99.5%; negative predictive value, 77.4% to 97.8%; diagnostic accuracy, 88.6% to 99.0%, respectively. The diagnostic accuracy of breast FNAC was significantly improved by adding LBC-p63 immunostaining.

Clinical radiological and pathological assessment of benign breast lumps: our institutional experience

Background: With increased awareness about breast cancer, many women with breast lumps are attending clinics. Though benign breast lumps are most common, they may be associated with morbidity and have become cause for concern to patients. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. Even in cases of benign breast diseases, multimodality tests are being preferred to give reassurance to patients. This study was aimed to study distribution of various benign breast lumps in relation to age at presentation, to identify sensitivity and specificity of clinical breast examination, Ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods in the evaluation of benign breast lumps and to compare with final histopathological diagnosis.Methods: A retrospective study was conducted in department of general surgery at Malla Reddy institute of medical sciences, Hyderabad from August 2013 to July 2017. 202 females with benign breast lumps were evaluated by clinical breast examination, ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods. All patients underwent excision biopsy of lump. Final histopathological report was taken as reference standard.Results: Fibroadenoma was most common in 2nd decade. Clinical breast examination and USG showed good sensitivity but less specificity than FNAC. FNAC showed both good sensitivity and specificity. There was very good degree of agreement between FNAC and histopathological diagnosis (Kappa=0.911).Conclusions: Good clinical examination can give accurate preoperative diagnosis of benign breast lumps. Triple assessment by clinical breast examination, USG and FNAC can be useful in the evaluation of benign breast lumps.

Atypical aspirates of the breast: a dilemma in current cytology practice

AimsThe probabilistic approach is widely adopted for breast fine needle aspiration cytology. However, a definite cytological diagnosis is not always possible for C3 (atypia) cases, which poses a management dilemma...

Application of National Cancer Institute recommended terminology in breast cytology.

There is a lack of uniformity with regard to the reporting terminology used in breast cytology by pathologists worldwide, resulting in miscommunication of results among health-care providers. The present study was aimed to assess the accuracy of fine-needle aspiration cytology (FNAC) in the evaluation of breast lesions using the National Cancer Institute (NCI) recommended terminology. In this prospective study, a total number of 523 breast FNACs were categorized according to the NCI guidelines. Of these, 286 (54.7%) had histopathological follow-up, and their FNAC diagnoses were compared. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) along with 95% confidence interval (95% CI) and accuracy of FNAC were calculated. Among 286 FNAC cases, 4 were unsatisfactory (C1), 188 were benign (C2), 11 were atypical, probably benign (C3), 21 were suspicious, favor malignancy (C4), and 62 were malignant (C5). On histopathological examination of categories C2 and C3 (total of 199 cases), 193 were confirmed as benign (true negative) and remaining 6 cases were turned out to malignant (false negative). Among categories C4 and C5 (total of 83 cases), 81 were confirmed as malignant (true positive) and remaining 2 were turned out to be benign (false positive). The sensitivity, specificity, PPV, NPV, and accuracy of FNAC were 93.1% (95% CI, 88.2%-95%), 99% (95% CI, 96.8%-99.8%), 97.6% (95% CI, 92.5%-99.6%), 97% (95% CI, 94.9%-97.8%), and 97.2%, respectively. Our study concluded that FNAC reporting using NCI guidelines highly correlated with the histopathological diagnosis.

Is FNA Still a Useful Tool in the Diagnosis of Breast Masses? A 5-Year Review with Cytohistopathologic Correlation

Introduction. Breast cancer is the most common cancer among women worldwide. In the Philippine National Cancer registry, 1 in every 13 Filipino women is likely to suffer from breast cancer. Fine needle aspiration cytology (FNAC) is a safe, accurate, fast and economical technique practiced worldwide in breast cancer diagnosis. Objective. To assess the value of FNAC as a rapid diagnostic tool in the local setting with the expectation to provide an immediate and highly reliable diagnosis in more than 90% of breast lesions. Methodology. From January 2010 to December 2014, there were 306 out of 1465 breast FNAC documented cases with histopathological correlation. The FNAC smears were retrieved, retrospectively reviewed blindly and reclassified into 5 categories (C1- C5). All FNAC were performed by pathology residents, pathologists and cytopathologist. Smears were fixed in 95% ethyl alcohol and stained with Papanicolaou method. Results. The FNAC findings showed: 13 (4.25%) unsatisfactory (C1); 160 (52.29%) benign (C2); 23 (7.52%) atypical (C3); 9 (2.94%) suspicious (C4) and 101 (33.01%) malignant cases (C5). There were 120 (39.22%) malignant and 186 (60.78%) benign lesions. There were 3.92% (12/306) false negative and 0.65% (2/306) false positive cases. The FNAC had 90% sensitivity, 99% specificity, 98% positive predictive value, 99% negative predictive value and 95% accuracy. The risks of malignancy for each category were: C1=15%; C2=4%; C3=13%; C4=78% and C5=100%. Conclusion. Despite the increasing preference for core needle biopsy among surgeons, FNAC continues to be an acceptable, affordable, quick and valuable tool contributing significantly to early breast cancer diagnosis and treatment, particularly in developing countries like the Philippines. Owing to its high sensitivity and specificity, it can be used as a screening and confirmatory diagnostic tool. Malignant and benign interpretations of breast FNAC give highly accurate prediction of outcomes but must be correlated with clinical and mammographic findings.

Comparison of Ultrasonography and Fine Needle Aspiration Cytology in the Diagnosis of Malignant Breast Lesions in a Rural Setup

Abstract Introduction: Breast cancer is the most common cancer diagnosed in women worldwide. These rising trends have emphasized the need of prompt detection, effective clinical evaluation, and exact diagnosis of the breast disease. Aim: To analyze and compare the sensitivity, specificity, and predictive values and accuracy of ultrasonography (USG) and fine needle aspiration cytology (FNAC) in diagnosing malignant breast lump. Materials and methods: A cross-sectional, prospective study was done. One hundred sixteen female patients attending surgery department with breast lump were included. After complete clinical evaluation of the lump, all patients underwent USG and FNAC examination for diagnosis of the lump, and further subjected to excisional biopsy/definitive surgery, the results of which were further compared with the histopathological results to determine the accuracy, sensitivity, specificity, and predictive values of FNAC and USG. Results: Out of 116, 61 (52.58%) benign lesions were found while the remaining 55 (47.41%) resulted to be malignant lesions on histopathological examination (HPE). Ultrasonography reported 46 true positive, 60 true negative, and 4 false negative cases with 6 inconclusive reports; whereas, FNAC reported 47 true positive, 61 true negative, and 6 false negative cases with 2 inconclusive reports. There were no false positive cases detected by USG and FNAC. Thus, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for USG was found to be 92, 100, 100, 93.75, and 96.36% (χ2-value = 94.88, p-value = 0.0001,S) and values of 88.68, 100, 100, 91.04, and 94.73% were obtained for FNAC respectively (χ2-value = 92.04, p = 0.0001,S). Conclusion: In diagnosing malignant breast lesion, USG and FNAC are 100% specific. Although USG appears more sensitive than FNAC, the percentage of indeterminate report is higher with USG.

Idiopathic Granulomatous Lobular Mastitis Masquerading as a Breast Tumor: A Case Report

IntroductionIdiopathic granulomatous lobular mastitis (IGLM) is an inflammatory disease of the breast with an obscure etiology. It occurs mainly in women of reproductive age, and the lesion mimics carcinoma of the breast both clinically and radiologicallyCase PresentationWe present the case of a 29-year-old female who visited our hospital in Kancheepuram, Tamil Nadu, with a 4 × 3 cm lump in the upper outer quadrant of her left breast. The clinical and radiological findings were indicative of a malignant lesion; however, fine-needle aspiration cytology (FNAC) revealed features of granulomatous mastitis, and the subsequent histology of the excised lump confirmed the diagnosis of IGLM.ConclusionsIGLM should be considered as one of the differential diagnoses when granulomas are encountered in breast FNAC and biopsy. A definitive diagnosis of IGLM can be made by identifying its characteristic histomorphology and ruling out other causes for granulomatous inflammation. An exact diagnosis is essential since the treatment for different granulomatous conditions of the breast varies.

簡易ギムザ染色を併用した乳腺穿刺吸引細胞診

簡易ギムザ染色を併用した乳腺穿刺吸引細胞診

Role of triple test score in the evaluation of palpable breast lump.

Introduction:Fine-needle aspiration cytology (FNAC) method is safe, reliable and time saving outdoor procedure with little discomfort to the patient for detecting Carcinoma breast. The efficacy can further be enhanced when physical breast examination, mammography and FNAC (the triple test [TT]) are jointly taken into consideration.Aims and Objectives:The aim was to evaluate the role of TT score (TTS) in palpable breast masses.Materials and Methods:This prospective study was carried out from May 2010 to April 2012. In the subjects referred to the Department of Pathology for FNAC of the breast mass, the TTS was calculated, and histopathological findings were noted.Results:In the study period TTS score was calculated in 200 cases out of 225 FNAC's of breast. Of 124 benign cases on cytology, only three showed discordant TTS. Out of 62 malignant cases, 61 showed concordant TTS and one case of mastitis on histopathology showed TTS of five. Out of all the benign lesions, two cases of fibrocystic disease and a single case of phylloides tumor gave a TTS ≥6. These cases were diagnosed as infiltrating ductal carcinoma and angiosarcoma respectively on histopathology. Histopathological correlation was possible in only 70 patients. Of these 70, 28 were from the benign category and 42 were from the malignant category. TTS of ≥6 has a sensitivity of 97.44%, specificity of 100%. FNAC has a sensitivity of 88.37%, specificity of 96.42%.Conclusions:TT reliably guides evaluation of palpable breast masses. Histological correlation indicated TTS to be better diagnostic tool than FNAC alone.

Evaluation of modified triple test (clinical breast examination, ultrasonography, and fine-needle aspiration cytology) in the diagnosis of palpable breast lumps

Objective: To find out the accuracy of the modified triple test in the diagnosis of palpable breast lumps. Materials and Methods: This was a cross-sectional study involving 50 female patients with palpable breast lumps attending the Surgical Out Patient Department of the Regional Institute of Medical Sciences, Imphal between October 2011 and September 2013, who underwent clinical breast examination (CBE), ultrasonography (USG), and fine-needle aspiration cytology (FNAC). All the cases irrespective of results underwent either excisional and or incisional biopsy for confirmation. The final histopathological report was considered the reference standard. Results: A total of 50 patients were included. The age range was 18-56 years. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CBE were 66.6%, 100%, 100%, 90%, and 91.6% respectively; those of USG 91.6%, 100%, 100%, 97.3%, and 97.9% respectively; and those of FNAC 91.6%, 100%, 100%, 97.4%, and 98% respectively. Out of 50 patients, the three tests concurred in 42 (35 benign and 7 malignant) cases. When all the three tests concurred, there were no false positive or false negative cases, and sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were all 100%. Conclusion: The triple test is valid and reliable, with a high degree of accuracy for the diagnosis of breast lumps. Of all the three components of the triple test, FNAC is the most accurate. A patient with a concordant benign triple test report can be safely followed up without the need for biopsy.

Correlation between Fine-Needle Aspiration Cytology and Histology for Palpable Breast Masses in a Nigerian Tertiary Health Institution.

Background. Management of breast lumps can be challenging in resource poor settings. Fine-needle aspiration cytology (FNAC) especially when used with cell block can help improve affordability for the patients. Objective. To determine the diagnostic accuracy of FNAC of palpable breast lesions within a 5-year period. Methods. The findings obtained from FNAC of palpable breast lumps seen at the FNAC clinic of our department from January 2007 to December 2011 were retrieved and correlated with findings on histology of excisional biopsies. Results. A total of 1790 patients had FNAC of breast lumps during the 5-year period; 436 of them subsequently had biopsies. Our results compare favourably with the measures of test performance of the UK NHS Breast Screening Programme shown in brackets: absolute sensitivity 95.4% (>70%), complete sensitivity 99.2% (>90%), full specificity 88.9% (>65%), positive predictive value 99.6% (>99%), false-negative rate 0.8% (<4%), false-positive rate 0.4% (<0.5%), inadequate rate 3.2% (<15%), and suspicious rate 10.2% (<15%). Conclusion. Breast FNACs compare very well with histology of excisional biopsies and in experienced hands are extremely useful in the management of breast lumps. Further studies assessing the diagnostic accuracy of FNAC and cell blocks in our setting are recommended.

Fine needle aspiration cytology of male breast lesions - a retrospective study over a six year period.

Fine needle aspiration cytology (FNAC) has a well-established role in the management of palpable breast lumps. However breast masses in males are rarely aspirated and hence there is limited cytopathologic experience. The aim of our study was to determine the efficacy of FNAC in the diagnosis of male breast lesions and also we attempted to describe the cytomorphological features of some of these lesions. Data on male breast FNAC done between 2008 to 2013 were retrieved from the records of the cytopathology laboratory. FNAC diagnosis were categorized as benign, malignant, suspicious for malignancy and inadequate or unsatisfactory. Cytohistologic correlation was done with data from histopathology records. Sensitivity, specificity and diagnostic accuracy were calculated using standard statistical methods. Forty out of 1098 patients undergoing breast FNAC were males. Histopathology was available in 8 (20%) out of 40 cases. There were no false positive or false negative diagnoses. FNAC had a sensitivity, specificity and diagnostic accuracy of 100% for male breast lesions. FNAC is a very accurate tool for the diagnosis of male breast lesions. It is highly sensitive and specific with good cytohistologic correlation. To reduce the high rate of surgical biopsies of benign male breast masses, we conclude that FNAC should be performed as a standard procedure in the clinical evaluation of male breast lesions.

Cytological study of palpable breast lumps (407 cases) with their histological correlation

Background: In India a large number of patients have been suffering from breast cancer and with each passing year, the number is increasing. Fine needle aspiration cytology (FNAC) is an inexpensive, simple and highly accurate means of diagnosing both benign and malignant breast lesions. The procedure provides a rapid and non-morbid diagnosis before the operation which enables the patient and the surgeon to discuss and plan therapeutic alternatives in a rational atmosphere. Aims & Objective: To find out the common causes of breast lesions, to evaluate role of FNAC in the diagnosis of them, their risk categorization for development of cancer and to conduct cytohistological correlation wherever possible. In addition the sensitivity, specificity, positive & negative predictive value of FNAC in breast lesions are carried out. Material and Methods: The present study was carried out on 407 patients who presented with palpable lump in the breast in the Department of Pathology, Government Medical College, Ahmedabad over a period of one year. FNAC slides were examined under light microscope after H&E, Papanicolaou & May-Grunwald –Giemsa staining and were categorized as Unsatisfactory sample, inflammatory, Benign, Atypical probably benign, suspicious probably malignant and Malignant. Cytological Diagnosis was correlated with histological findings wherever possible. Results: Cytologically, the lesions were categorized in, Unsatisfactory 28 (6.87%), inflammatory 64 (15.72%), Benign 229 (56.26%), Atypical probably benign 8 (1.96%), suspicious probably malignant 8 (1.96%) and Malignant 70 (17.19%). Out of these 407 cases, 161 cases (39.55%) were available for histopathological examination. The most common benign lesion in this study was fibroadenoma 178/229 (77.72%) and the most common malignant lesion was infiltrating ductal carcinoma 51/70 (72.85%). The sensitivity and specificity of FNAC came out to be 98.08%, 98.86% respectively& positive & negative predictive value of FNAC were 99.35% &96.66% respectively. Conclusion: The FNAC of breast is cheap, safe and highly accurate preoperative method for diagnosis of breast lesions. Preoperative categorization of breast lesions is utmost important for management of the patient.