Clinicocytological and Histopathological Comparision of Palpable Breast Masses in and around Jabalpur
Keywords:fine needle aspiration cytology, infiltrating duct carcinoma, fibroadenoma, sub-category, diagnostic accuracy.
Introduction: Breast lesions are a heterogeneous group of disorders ranging from inflammatory lesions to invasive cancers.1 Diseases of the breast are showing a rising trend worldwide; from 1.05 million in 2000 to 2.08 million in 2018, the cases of breast cancer almost doubled up in 8 years.2 At of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer. The accuracy of diagnosis can be increased by a combination of preoperative tests (like physical examination, mammography, fine-needle aspiration cytology, and core needle biopsy). These modalities are more accurate, reliable, and acceptable when compared with a single adopted diagnostic procedure despite of having their own technical limitations.3 Fine needle aspiration cytology (FNAC) is a relatively safe, quick, easy and a cheap diagnostic tool to decipher the benign or the malignant nature of the swelling. based on NHSBSP of Britain cytology was subclassified into 5 categories C1- C5. This study was conducted to document the spectrum of breast lesions encountered in a tertiary care centre in FNAC and sub classify them. Materials and Methods: A total of 90 cases of breast lesions which were referred for FNAC to the Department of Pathology, were evaluated. All of these patients presented with palpable swelling and a clinico- cytological and histological correlation was done. FNACs were performed and both air dried and alcohol-fixed smears were prepared and stained with haematoxylin and eosin. The adequacy of the diagnostic material and the results of FNAC were reported. Results: Out of the total of 90 cases of breast lesions on which FNAC were done and evaluated, there were 92 females and 3 males. The clinical diagnoses were confirmed by cytology. Fibroadenoma (60.32%) was the most common benign cytological diagnosis followed by fibrocystic disease (6.35%) and ductal carcinoma (62.96%) was the most common diagnosis in malignant category. FNAC was false negative in six cases; 01 case was fibrotic tissue; two cases were diagnosed as fibro adenosis and 3 cases were diagnosed as of carcinoma. The sensitivity, specificity, PPV , NPV and diagnostic accuracy of FNAC in diagnosing benign breast lesions were 98.41% ,85.19%, 93.94% ,95.83 % and 94.44% respectively while the sensitivity, specificity, PPV , NPV and diagnostic accuracy of FNAC in diagnosing malignant breast lesions were 85.19 % ,98.41%, 95.83% ,93.94 % and 94.44%.
Conclusion: FNAC is rapid, accurate, minimally invasive, outpatient-based procedure and helps in diagnosis of benign and malignant breast lesions and involvement in experienced pathologist chances of false results are less.
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Copyright (c) 2022 Radhika Rajesh Nandwani, Vijay Shrivastava, Shruti Mehta
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