EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF BREAST LUMPS

Abstract

Objective: To determine the sensitivity and specificity of fine needle aspiration cytology (FNAC), by

comparing the results with excision biopsy.

Material and Methods: 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.

Results: 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.

Conclusion: 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%.