Comparison of FNAC and open biopsy in palpable breast lumps

Abstract

Objective: To compare the results of FNAC and open biopsy in patients presented with palpable breast lump.

Design: Comparative study.

Place and duration of study: Nishtar Hospital, Multan, during the period of October 2001 to October 2003.

Patients and methods: All female patients, irrespective of their age, who presented with breast lump were included in the study. The patients were divided into two groups, group I & II of clinically benign and clinically malignant respectively. Both groups underwent FNAC. The patients with suspicious FNAC were subjected to excision biopsy in group I patients. Group II patients were advised surgery and final report was made on histopathology. Sensitivity and specificity of the FNAC was determined.

Results: A total of 89 cases were included in whom both FNAC and histopathology results were available for comparison. Clinically, 54 were benign and 35 were malignant. The cytological diagnosis was unequivocally malignant in 29 patients, suspicious in 3 cases, unequivocally benign in 44 patients and probably benign in 7 patients while specimen was inadequate in 6 patients. Histological diagnosis of these 89 patients showed 55 patients with benign disease and 34 patients having malignant disease. In malignant disease, sensitivity of the FNAC was 85.29% with 100% specificity, 14.7% false negative rate, 100% positive predictive value and 98.79% negative predictive value.

Conclusion: FNAC has good sensitivity (85.29%) and very high specificity (100%). It can replace the open biopsy in majority cases of clinically malignant disease. Although FNAC is slightly less sensitive (80%) in benign diseases, it is highly specific (100%), so it can help to reassure and relieve the anxiety of the patients.