Diagnostic Accuracy of Fine Needle Aspiration Cytology In Palpable Breast Lump Taking Histopathology As Gold Standard

Abstract

Background: Problems in the breast can present themselves in different ways like pain in the breast, discharge from nipples, cystic lesions and most commonly a lump.  Breast lump is of great concern to the patients and is also challenge to the diagnostic acumen and judgment of the surgeon. This will be beneficial in early diagnosis and treatment, reducing its morbidity and mortality more over this study will provide us with local statistics of the magnitude of breast lump and this will open window for further research.

Objective:  To determine the diagnostic accuracy of FNAC of breast lump with the histopathology as a gold standard in diagnosis of breast cancer.

Material and Methods: The current study was conducted at Department of General Surgery, Khyber Teaching Hospital, Peshawar for six month (from 2/7/2019 to 27/01/2020). A total of 179 women were observed in which women presenting with palpable breast lump, in age between 35 years to 60 years were included.  Fine-needle aspiration cytology (FNAC) of the patients with breast lump was performed with 22-gauge needle, mounted on a 10-ml syringe. Excision biopsy was done for small tumors or lump found benign on fine needle aspiration cytology and histopathology of mastectomy. Histopathological slides of corresponding cytological cases were correlated. The collected data was entered and analyzed in SPSS version 22. Sensitivity, specificity, positive predictive value and negative predictive value of FNAC were calculated.

Results: Our study shows that among 179 patients, mean age was 53 years ± 10.45. FNAC had sensitivity 90.22%, specificity 80%, PPV 99.36%, NPV 19.04% and diagnostic accuracy was 89.94% in the diagnosis of breast lump keeping histopathology as a gold standard. 

Conclusion: Our study concludes that Fine needle aspiration cytology (FNAC) is a simple, safe and minimally invasive diagnostic test that is accurate in detecting breast lumps, with a high correlation rate to histopathology. When used in conjunction with histopathology, FNAC can ensure an accurate diagnosis and appropriate management of breast lumps.