FNAC – A Valuable Tool in Diagnosing Breast Lesions and its Correlation with Histopathology

Abstract

Background: Fine needle aspiration cytology (FNAC) is a renowned diagnostic tool to assess palpable lesions worldwide. It is easy, cost effective, widely accepted, minimally invasive, safe, rapid, comparatively painless, out-patient based and inexpensive technique. Based on the cytological findings especially in breast lesions, a diagnosis can be made and further evaluation and treatment can be planned in most cases without further invasive investigations. Objective: To evaluate diagnostic utility of fine needle aspiration cytology in palpable breast lesions and to compare the result with histomorphological diagnosis in the cases draining at Madinah Teaching Hospital (MTH), in a decade. Study Design: Retrospective analysis. Settings: Cytology clinic of Pathology Department, Madinah Teaching Hospital, Faisalabad Pakistan. Duration: From January 2011 to December, 2020. Methods: Data from female patients aged between 10 to 65 years presenting with breast lump and undergoing FNAC followed by histopathology of resected specimen were included. Standard procedure of FNAC and Histopathology were followed in all cases. Results: FNAC of 663 patients was included out of which 392 were benign and 271 were malignant. Fibroadenoma was most common benign entity followed by fibrocystic disease. In malignant variants, invasive intraductal was common followed by in situ carcinomas. Cyto-histological correlation was done in 630 cases - 366 benign and 264 malignant out of which 2 benign cases were found to be false negative on FNAC. Accuracy of FNAC was 99.02%. Conclusion: FNAC is vital in diagnosing breast lesions on the basis of palpation, examination and cytology. In comparison to Histopathology, FNAC has a high Accuracy and specificity with very low false negative rate. Combined with mammography or other easy accessible radiological adjuncts (triple assessment), presumptive diagnosis can be made and invasive procedures can be avoided.