Comparison of fine needle aspiration cytology with excision biopsy of breast lump

Abstract

Objective: To evaluate the results of fine needle aspiration cytology (FNAC) of breast lump by histopathology of excision biopsy specimen in the same group of patients.

Design: A descriptive study.

Place and duration of study: Department of Surgery, Federal Government Services Hospital, Islamabad from October, 2000 to March, 2001.

Materials and methods: There were 50 patients in the study, who were subjected to fine needle aspiration cytology with a needle of 22G mounted on 20 cc syringe. Smears were fixed on the slides with 95% alcohol and later stained with hematoxylin and eosin stain. After FNAC, all the patients were subjected to excision biopsy. The specimen were reported by the Histopathologist and results evaluated and compared.

Results: All patients were among the total number of 61 FNAC performed, conclusive malignancy (C5) was found in 20(40%) patients and in 1(2%) patient, malignancy was suspected (C4). Conclusive benign lesions (C2) were found in 26(52%) patients and 2 patients had atypia i.e. (C3). Inadequate specimen (C1) was found in 2(4%) patients. On excision biopsy, 22(44%) patients had malignant lumps and 28(56%) benign. FNAC was able to detect 20 malignant lumps with sensitivity of 90.90%. All of them were also reported malignant on excision biopsy with specificity of 100%. False positive were zero and false negative were 9.1%.

Conclusion: FNAC is simple, quick, safe, tolerable, cosmetically acceptable, reliable and cost-effective method of determining histology of breast lumps. The absence of false positives conclusively confirmed its place not only as a complimentary adjunct but also a substitute of excision biopsy in majority of instances.