Accuracy of Fine Needle Aspiration Cytology in Comparison with Histopathology in the Diagnosis of Breast Lesion 2016-2017

Abstract

Background : Breast lump is a common presentation in the surgical outpatient department with increasing awareness of both patient and clinician . The diagnosis of nature of a breast lump was based on the triple assessment protocol which includes clinical examination , radiological imaging and histopathologic examination . Despite that the histopathological diagnosis is a gold standard method for nature of breast lump diagnosis , fine needle aspiration cytology is easy , rapid , reliable and less expensive method with high sensitivity , specificity and accuracy rate . Objective :To assess the diagnostic accuracy of fine needle aspiration cytology in palpable breast mass.Methods : A total of 73 female patients with palpable breast mass were included in this prospective cross sectional study which was performed in Al-Zahraa Teaching Hospital , College Of Medicine , University Of Wassit from September 2016 to February 2017 .All female patients were selected randomly irrespective of their age , marital status , occupation and social status .All female patients underwent fine needle aspiration cytology in the department of pathology by expert pathologists, then every patient underwent a definitive surgical procedure (excisional biopsy )and sent for histopathology .The results of fine needle aspiration cytology were interpreted as unsatisfactory , benign ,suspicion of malignancy, and malignant lesion .Then fine needle aspiration cytology results were correlated with those of histopathology to give an assessment of diagnostic accuracy of fine needle aspiration cytology .Results : A total of 73 female patients with palpable breast mass were included in this study . In 41 patients ,the breast lumps were malignant while in 32 patients the breast lumps were diagnosed as benign .No patient had false positive results but,4 patients had false negative results . The sensitivity and specificity of fine needle aspiration cytology for detecting malignancy were 90.24 % and 100 % respectively. The positive predictive value (PPV ) and negative predictive value (NPV) of fine needle aspiration cytology for malignancy were 100 % and 88.88 % respectively .The accuracy of fine needle aspiration cytology was 94.52 % .Conclusion : FNAC has high accuracy for the diagnosis of the pathologic nature of breast lump . Thus , we conclude that FNAC is an ideal method of investigation of palpable breast lump if being performed by expert hands and the results show high degree of correlation with the histopathologic results.