Abstract
Objective: Worldwide, the most accepted protocol for diagnosis of breast lumps is “Triple Assessment”, which includes clinical assessment, radiological imaging and pathological diagnosis. FNAC forms the most important aspect of cytopathology as a part of triple assessment. The aims of present study were to evaluate our results of aspiration cytology of breast lump and to establish the diagnostic accuracy of the technique by comparative evaluation with histopathological diagnosis of respective breast lump.
Materials and Methods: A prospective study of 50 patients was conducted at Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. Patients were randomly selected, irrespective of their age, sex, religion, marital status, occupation or social status. FNAC was performed on 50 patients with breast lump attending the surgical OPD and admitted in the surgical ward. Irrespective of clinical diagnosis, patients underwent FNAC when a lump was palpated by Surgeon and subsequently every patient underwent a definitive surgical procedure for histopathological examination. The results thus obtained from FNAC and histopathology was matched and a correlation was obtained based on statistical tests.
Results: Age group of the patients ranged from 16 to 65 years. There were only one male patient of gynaecomastia and all other 49 were females. Statistical analysis was performed on the tabulated data and accuracy with false positive and false negative results were obtained. Accuracy of malignant lesions was 90%. Among benign lesions, gynaecomastia and chronic mastitis were diagnosed with 100% accuracy. The accuracy rate in diagnosing fibroadenoma and fibroadenosis was 90% and 85.71% respectively. Thus overall accuracy rate found to be 90%.’
Conclusion: FNAC of breast is simple, cost effective and less traumatic method for diagnosis of breast lump. FNAC can provide a preoperative diagnosis with reasonable accuracy as compare to histology. In advanced carcinoma or unwilling patients for surgery, it can form the basis of management. So FNAC should be used as a routine method for determining the nature of breast lump.
Keywords: FNAC, breast lump, neoplasm.
References
- Kreuzer,G. and Zajicek,J. Cytologic diagnosis of mammary tumors from aspiration biopsy smears. Acta.Cytol. 16:249. 1972.
- Zadjela,A. The value of aspiration cytology in diagnosis of breast cancer. Experience at the Foundation Curie. Cancer. 35:499. 1975.
- Furnival et al. Aspiration cytology in breast cancer, its relevance to diagnosis. Lancet, 2:446. 1975.
- Gupta et al. Evaluation of needle biopsy in the diagnosis of tumor. Indian J. of cancer. 12:257. 1975.
- Cytologic presentation of mammary carcinoma on aspiration biopsy smears. Acta.Cytol. 20:469. 1976.
- Struve-chirstensen,E. Itrogenic dissemination of tumor cells. Dan. Med. Bull. 25:82. 1978.
- Zajicek, J. The aspiration biopsy smear in Diagnostic cytology and its Histopathologic bases Ed. by Koss L.G. Vol 2. 534 Philadepphia. J.B.Lippincott co. 1979.
- Ferruci,J.T. et al. Malignant seeding of the tract after thin needle aspiration biopsy. Radiology. 130:345. 1979.
- Gupta et al. Aspiration cytology in the diagnosis of breast cancer. Indian Jr. of cancer. 16:1. 1979.
- Singh et al. Aspiration cytology in diagnosis of breast lumps. Indian Jr. Surg. 556. 1980.
- Martin,R.E. and Graham,R. Office evaluation of breast tumor, with emphasis on needle aspiration therapy. Md. State Med. Jr. 31(9):51. 1982.
- Frable, W.J.; Fine needle aspiration biopsy: A Review. Hum. Patho. 14(1) 9. 1983.
- Holmer,M.J. et al. Outpatient needle localization and biopsy for nonpalpable breast lesions. JAMA 252:2452. 1984.
- Smith et al. Accuracy and cost effectiveness of fine needle aspiration biopsy. Am. Jr. Surg. 149:540. 1985.
- Bansal, R.L., Sankaran, V.Valiath, A.J.; Role of fine needle aspiration cytology in the diagnosis of breast lumps and its histopathological correlation. J.Cyto. 2:62. 1985.
- Karcioglu Z.A., Gordon R.A., Karcioglu G.L., Tumor seeding in ocular fine needle aspiration biopsy. Ameri. Aced. Ophal. Vol. 2, 1763-1767, Dec. 1985.
- Dnadapat,M.C., Panda, B.K. Fine needle aspiration as a primary adjunct in the diagnosis of palpable breast lumps. Jr. Indian.M.A. 84(1):3. 1986.
- Sharma R., Mondol A., Sahoo M., Kakar A., Shankar L.R., Khanna C.M., Chopra M.K. : Journal of the association of physicians of India. 47(5); 488-91, 1999.
- Milde P. Sidawy M. K. : Department of pathology, The George Washington University edical centre, Washington , DC, USA Somce-cytopathology. 10(6) : 415;9, 1999.
- Shinohara S., Yamamoto E., Tanabe M., Maetani T., Implantation metastasis of head and neck cancer after fine needle aspiration biopsy. Scaud. J. Urol. Nephrol. 1:270-276. 2001.
- Khatun,H., Enam,S., Hussain,M., diagnostic role of fine needle aspiration cytology in the breast lumps with its correlation with histopathology. TAJ; 14(2):65-69. 2001.
- Tiwari M.; Role of FNAC in the diagnosis of breast lumps. Katmandu Univer. Medi. Jr.; vol.5. no.2 18,215-217. 2007.
- Osako, T., Iwase,T., Takahashi,K., Miyagi,Y., Diagnostic Mammography and US for palpable and non palpable breast cancer in women aged 30-39 years. Jap. Breast Cancer Soci. 14(3):255-9. 2007.
- Silva M.A., Hegab B., Miraz D.F., Buckeb JAC., Needle tract seeding following biopsy of liver lesion in the diagnosis of Hepatocellular carcinoma. Brit. Med. J. 57:1592-1596. 2008.
- Khemka, A., Chakraberti,N., Sah,S., Patel, V., Palpable breast lumps: fine needle aspiration cytology verse histopathology, a correlation of diagnostic accuracy. Int.J.of surg.18(1). 2008.
- Reyes C.V., Reyes E.A. : The role of fine needle aspiration cytology in medical-surgical missions. Acta Cytol. 53(5):524-6. 2009.
- Khan,N., Afroz,N. and Khan,M.A. Role of cytological grading in prognostication of invasive breast cancer. Jr. Cytol. 26(2):65-68. 2009.
- Bukhari, M.H., Arshad,M., Jamal,S., Niazi,S., use of fine needle aspiration cytology in evaluation of breast lumps. Patho. Resch.Intr. 2011:10.
- Danny R. Youlden., Susanna M.C., Nathan A.M.D., The descriptive epidemiology of female breast cancer; an international comparison of screening, incidence, survival and mortality. Cancer epidemiology, 36:237-248. 2012.
- Smsa Chaudhary, MK Alam, MS Haque.; The Role of FNAC in Diagnosis of Breast Disease at Different Ages. Jr.of Bangladesh. College of physician and surgeons. Vol.30,No.3. 2012.
- Kaarthigeyan, K. Cervical cancer in India and HPV vaccination. Indian Jr. Med. 33(1):7-12. 2012.
- Global Health Estimates, Breast cancer: prevention and control, WHO 2013.
- Rosai and Ackerman’s: Surgical Pathology, 10th vol 2, Page, 1660-1733. 2014.
- Orell and Sterrett’s: Fine Needle Aspiration Cytology, 5th Page, 9-18,156-202. 2014.
- Robbins and Cotran: Pathological Basis of Disease, South Asia Ed.vol 2, Page 1043-1070. 2015.
- S. Breast cancer; Indian experience, data and evidence. South Asian Jr. Cancer. 5(3):85-86. 2016.
- Sreedevi,C.H., Pushpalatha,K., Correlation of fine needle aspiration cytology and histopathology for breast lesions. Trop.J.of Pathol. and Micro. 2(3) 2016.
- Ghoncheh, M., Momenimovahed,Z., Salehiniya, H., Epidemiology, incidence and mortality of breast cancer in Asian Pac. J.Cancer prev. 17(s3):47-52. 2016.
- Maheshwari, A., Kumar,N., Mahantshetty, U., Gynecological cancer: A summary of publication Indian data. South Asian Jr. cancer 5(3):112-120. 2016.
- Kocaay,A.F., Celik,S.U. and Alic, K.B. Role of fine needle aspiration cytology and core biopsy in the diagnosis of palpable breast masses. N.M.Jr. 57(2):77-80. 2016.
Corresponding Author
Dr Satyendu Sagar
Assistant Professor, Department of Microbiology, NMCH, Patna
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.56
