Accuracy of fine-needle aspiration cytology in the diagnosis of breast cancer a single-center retrospective study from Turkey with cytohistological correlation in 733 cases

Abstract

Background: The triple test, i.e., cytology combined with clinical and radiological findings, is the goal for accurate assessment of palpable breast lesions. Because of the limitations of fine-needle aspiration cytology (FNAC), its utility has somewhat decreased nationwide. We have been using a combination of physical examination, radiological modalities, and FNAC for the diagnosis of palpable/nonpalpable breast mass lesions for the last 23 years. Our institutional experience of the last 10 years is presented here, using FNAC of breast lesions along with an analysis of the diagnostic accuracy.

Methods: 4956 breast aspirates in 4860 cases were collected from the computer database of Haydarpasa Numune Education and Research Hospital in Istanbul, Turkey. Most of the FNACs were performed under ultrasound guidance and FNAC procedures were performed by radiologists and pathologists who used 22 gauge needles. Cytological diagnoses were classified as "unsatisfactory", "benign", "malignant", "atypical/probably benign", "atypical/probably malignant", and "atypical/NOS" (not otherwise specified) and were compared to the histopathological diagnoses obtained from core needle biopsy, lumpectomy or mastectomy to give an assessment of the diagnostic performance of FNAC in 733 aspirates.

Results: The sensitivity, specificity, accuracy, positive and negative predictive value, false positive, and false negative rates of FNAC were 98.02, 90.58, 95.97, 96.48, 94.54, 2.6, and 1.4%, respectively.

Conclusions: This study once again shows that FNAC is a reliable method for the initial evaluation and diagnosis of breast masses. In case of any suspicious conditions, FNAC, and core biopsy are considered complementary to one another.

Keywords: breast; efficacy; fine-needle aspiration cytology.