Abstract
Background: In women, malignancy of breast imposes significant reduction in life span. So, FNAC is a widely accepted cytological technique in the early diagnosis of palpable breast lesions. For making further appropriate therapeutic decision intra-operative frozen section is used. Ultimately, histopathological study remains the confirmatory test in final diagnosis of breast lesions. There have been many studies of comparison of efficacy of FNAC, Frozen section and histo-pathological study which has been shown to be high in many centres.
Aim: To compare cytological and histopathological diagnosis of breast lesions and Frozen section and histopathological diagnosis of breast lesions and to establish accuracy of each of them as an diagnostic aid.
Material and Methods: FNAC of 51 cases of palpable breast lesions were evaluated retrospectively between January 2018 to June 2019. Only those cases which underwent frozen section and subsequent histopathological follow‑up for confirmative diagnosis were included. FNAC, Frozen section diagnosis and Histopathological diagnoses then correlated to assess the efficacy in diagnosis of palpable breast lesions. Males and non-palpable breast lesions were excluded.
Results: The present study showed sensitivity, specificity, accuracy, positive predictive value, and negative predictive values of FNAC in relation to Histopathological diagnosis of breast lesions as 94.44%, 84.85 %, 88.24%,77.27%, and 96.55% respectively. Also the present study showed sensitivity of 88.89%, specificity of 87.89%,positive predictive value of 80.00%, negative predictive value of 93.55% and accuracy of 88.24% on Frozen section in relation to Histopathological study.
Conclusion: FNAC is thus a rapid, cost-effective highly sensitive and highly specific first minimal invasive method in diagnosing breast lumps. But Frozen is also sensitive and specific and has also a definite role in settings like difficult cytology, evaluation of lumpectomy margins and intra operative nodal status. But the histopathological study is still considered as a gold standard in the final diagnosis.
Keywords: FNAC; Frozen section; Histopathological study; palpable breast lesions; Malignancy of Breast.
References
- Venugopal K, Balakrishna P, Nikshita N. FNAC Accuracy in Diagnosis of Breast lesions. Journal of Evolution of Medical and Dental Sciences. 2014;3(12):3062-9.
- Dennison G, Anand R, Makar SH. A prospective study of use of FNAC and core biopsy in the diagnosis of breast cancer. Breast Journal, 9(6), 2003, 491-493
- Pradhan M, Dhakal H. Study of breast lump of 2246 cases by fine needle aspiration. J Nepal Med Assoc, 47, 2008, 2059.
- Ariga R, Bloom K, Reddy VB, Kluskens L, Francescatti D, Dowlat K, et al. Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation. Am J Surg, 184, 2002, 410-3.
- Klein S. Evaluation of palpable breast masses. AmFam Physician, 71(9), 2005, 1731-8.
- Shabot M, Goldberg I, Schick P, Nieberge R, Pilch YH. Aspiration cytology is superior to Tru-cut needle biopsy in establishing the diagnosis of clinically suspicious breast masses. Ann Surg, 196, 1992, 122.
- Sayami P, Singh BM, Singh Y, Timila R, Shrestha U, Sayami G. Retrospective analysis of breast cancer cases and surgical treatment in a period of ten years. J Nepal Med Assoc, 40, 2001, 112-9.
- Bianchi S, Palli D, Ciatto S, Galli M, Giorgi D, et al. Accuracy and reliability of frozen section diagnosis in a series of 627 non palpable breast lesion. Am J Clinical Pathology, 103, 1995, 199-205.
- http://ec.europa.eu/health/ ph_projects/2002/cancer/ fp_cancer_2002_ext_guid_01.p
- Pandey JS, Sayami G, Dali S, Shrestha HG, Shrestha B, Adhikari RC, et al. Fine needle aspiration cytology of breast lump in TU Teaching Hospital. Nep. Med Assoc. 2002;41:388-91.
- Manohar P, Adhikari RC, Sigdel B, Basnet RB, Amatya VJ. Present cancer status in TU teaching hospital. JSSN. 1992;2:16-23.
- Hughes JE, Royle GT, Buchanan R, Taylor I. Depression and social stress among patients with benign breast disease. British Journal of Surgery. 1986;73 (12): 997-9.
- Ellman R, Angeli N, Christians A, Moss S, Chamberlain J, Maguire P. Psychiatric morbidity associated with screening for breast cancer. British Journal of Cancer. 1989;60(5):781.
- Shrestha HG, Dali S, Sayami G, Osti B, Amatya VJ, Basnet RB. Present cancer scenario and its changing pattern at TU Teaching Hospital, Nepal. J Nep Med Assoc. 1997;35:45-51.
- Reddy DG, Reddy CR. Carcinoma of the breast, its incidence and histological variants among South Indians. Indian journal of medical sciences. 1958;12(4): 228.
- Shah Alam Sheikh. et al. Journal of Science.2016; 6(3);191-201.
- Bajwa R, Zulfiqar T. Association of fine needle aspiration cytology with tumor size in palpable breast lesions. Biomedica. 2010;26:124-9.
- Rocha PD, Nadkarni NS, Menezes S. Fine needle aspiration biopsy of breast lesions and histopathologic correlation. An analysis of 837 cases in four years. Actacytologica. 1997;41(3):705-12.
- Kamphausen BH, Toellner T, Ruschenburg I. The value of ultrasound-guided fine-needle aspiration cytology of the breast: 354 cases with cytohistological correlation. Anticancer research. 2003; 23(3C):3009-13.
- Nggada HA, Tahir MB, Musa AB, Gali BM, Mayun AA, Pindiga UH, et al. Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions: a five-year review. African journal of medicine and medical sciences. 2007;36(4):295-8.
- Nguansangiam S, Jesdapatarakul S, Tangjitgamol S. Accuracy of Fine Needle Aspiration Cytology from Breast. Asian Pacific Journal of Cancer Prevention. 2009;10:1-4.
- Ahmed HG, Ali AS, Almobarak AO. Utility of fine needle aspiration as a diagnostic technique in breast lumps. Diagnostic cytopathology. 2009;37(12): 881-4.
- Pudasaini S, Talwar OP. Study of fine needle aspiration cytology of breast lumps and its histopathological correlation in Pokhara Valley. Nepal Medical College journal: NMCJ. 2011;13(3):208-12.
- Muddegowda PH, Lingegowda JB, Kurpad R, Konapur PG, Shivarudrappa AS, Subramaniam PM. The value of systematic pattern analysis in FNAC of breast lesions: 225 cases with cytohistological correlation. Journal of Cytology/Indian Academy of Cytologists. 2011;28(1):13.
- Yalavarthi S, Tanikella R, Prabhala S, Tallam US. Histopathological and cytological correlation of tumors of breast.Medical Journal of Dr. DY Patil University. 2014;7(3):326.
- Paramesh AS, Kariappa TM. Correlation of fine needle aspiration cytology and histopathology in palpable breast lesions in 100 patients of KVG Medical College & Hospital, Sullia, Karnataka. International Journal of Applied Research. 2015;1(8): 422-7.
- Daramola AO, Odubanjo MO, Obiajulu FJ, Ikeri NZ, Banjo AA. Correlation between fine-needle aspiration cytology and histology for palpable breast masses in a Nigerian tertiary health institution. International journal of breast cancer. 2015;1-5.
- Waghmare RS, Sakore DS, Rathod SB. Fine needle aspiration cytology of breast lesions and correlation with histopathology. Int J Res Med Sci. 2016;4: 4416-21.
- Ibikunle DE, Omotayo JA, Ariyibi OO. Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: a five-year review. Ghana medical journal. 2017; 51(1):1-5.
- Chauhan SC, Sarvaiya AN. Cytological and Histopathological Correlation of Breast Lump: A 3 Year Study at Tertiary Care Center. Annals of Pathology and Laboratory Medicine. 2017;4(3):A292-296.
- Farida Begum, P. Ravi Kumar. Diagnostic correlation of palpable breast masses by cytology and histopathology: A prospective study.IAIM.2018;5(11):44-49.
- Gardas V. Cytological study of breast lumps with histopathological correlation. Indian J Basic Appl Med Res. 2018;7:185-92
- Hanzal E, Gitsch G, Joura E, Dadak C, Breitenecker G. The value of intraoperative rapid biopsy study in diagnosis of breast cancer. Geburtshilfe und Frauenheilkunde. 1992;52(3):161-4.
- Hou MF, Huang TJ, Lin HJ, Sheen YY, Huang CJ, Huang YS, et al. Frozen section of diagnosis of breast lesions. Gaoxiongy-ixuekexuezazhi= The Kaohsiung journal of medical sciences. 1995;11(11):621-5.
- Haeri H, Djamali M, Ahmadinejad M. Comparison of the cytology technique and the frozen section results in intraoperative consultation of the breast lesions. Acta Medica Iranica. 2002:203-6.
- Karve PV, Jambhekar NA, Desai SS, Chinoy RF. Role of frozen section evaluation in patients with breast lumps: A study of 251 cases. Indian J Surg 2005; 67:241-5.
- Kayani N, Sultana N. Validity of frozen section in the diagnosis of breast lumps: 5 years experience at the Aga Khan University Hospital. Journal of Pakistan Medical Association. 2005;55(12):533.
- El-Bolkainy TM, Shabaan HA, Abodeif WT, El-Bolkainy MN, El-Tony A. Intra-operative diagnosis of breast mass-lesions: comparison of the validity of touch smear preparation and frozen section techniques. Journal of the Egyptian National Cancer Institute. 2008;20(1):63-9.
- Brunner AH, Sagmeister T, Kremer J, Riss P, Brustmann H. The accuracy of frozen section analysis in ultrasound-guided core needle biopsy of breast lesions.BMC cancer. 2009;9(1):341.
- Caruso F, Ferrara M, Castiglione G, Cannata I, Marziani A, Polino C, et al. Therapeutic mammaplasties: full local control of breast cancer in one surgical stage with frozen section. European Journal of Surgical Oncology (EJSO). 2011;37(10):871-5.
Corresponding Author
Dr Makode A.J.
Dr Shankarrao Chavan Medical College and Hospital, Vishnupuri, Nanded, India
DOI: https://dx.doi.org/10.18535/jmscr/v8i5.83
