value of fine needle aspiration cytology in the diagnosis of male breast lesions

ABSTRACT

The aim of this retrospective case series is to explore and highlight the subject of male breast diseases in Jeddah, Saudi Arabia and to assess the value of fine needle aspiration in diagnosing these lesions. Material and Data on male breast biopsies and fine needle aspiration cytology [FNAC] done between 1984 and 1999 were retrieved from the laboratory records. The same pathologist blindly examined all the cytology and histology slides. Histopathology diagnoses were classified into benign and malignant. FNAC diagnoses w e re categorized as positive, negative, inconclusive or unsatisfactory. Cytohistologic correlation was done with data from histopathology records. Sensitivity, specificity, and predictive values of FNAC were calculated using standard statistical methods. Our results were also compared with a similar large study. Sixty-three [6.0%] of 1044 patients undergoing breast surgical biopsies were males. Benign lesions comprised 55 cases [87.3%], but eight cases [12.7%] were malignant lesions [six ductal carcinomas and two metastatic adenocarcinoma]. Gynecomastia is the most common male breast lesion, constituting 54% [mean age 31.23 years]. Amajority [54%] of these patients presented near puberty. Twelve patients had cytohistological records for correlation, giving a sensitivity of 100%, specificity of 83.33%, positive predictive value of 85.71%, negative predictive value of 100%, false positive fraction of 8.3% and a false negative fraction of 0%. Male breast lesions constituted 6% of all breast lesions and male breast carcinomas constituted 2.59% of all breast carcinomas. This study also shows that FNAC is an accurate tool for diagnosing male breast lesions. It is highly sensitive and specific. FNAC should, therefore, be used confidently and be included as an integral part of primary assessment of breast lumps in males