Efficacy of fine needle aspiration cytology in the diagnosis of breast lumps

ABSTRACT

To determine the sensitivity and specificity of fine needle aspiration cytology [FNAC], by comparing the results with excision biopsy. This observational and comparative study was conducted in Surgical B Ward of Khyber teaching hospital Peshawar, Pakistan from August 2002 to May 2003. A total of 50 women, who had a clinically palpable breast lump were subjected to concurrent FNAC and excision biopsy. Out of 12 malignant lesions on excision biopsy, FNAC correctly diagnosed 9, and 2 were diagnosed suspicious, and the remaining one was misdiagnosed as non malignant. So false negative being 1/12 [8.3%]. Of 38 benign cases on excision biopsy, FNAC diagnosed correctly duct ectasia 3, tuberculosis 2, and galactocele 1, while out of 22 fibroadenoma, FNAC diagnosed 20, and 2 were diagnosed as unsatisfactory. Ten cases diagnosed as fibrocystic disease on excision biopsy, FNAC picked only 6 cases correctly. The one case diagnosed on FNAC as fibrocystic disease, turned out to be malignant on histology. The remaining 4 cases of fibrocystic disease diagnosed on histopathology were either reported as unsatisfactory [3 cases] or suspicious [1 case] on FNAC. The sensitivity and specificity of FNAC was 91.66% and 96.96% respectively. Breast cytology was an effective and rapid method of diagnosis of breast diseases. It helps in deciding which patient needs early open biopsy. A negative cytology does not exclude the possibility of malignancy, as there was a false negative rate of 8.3%