Diagnostic Accuracy of Fine Needle Aspiration Cytology (FNAC) In Palpable Breast Lesion
Muhammad Mudassar, Iman Ali, Loveeza Khan, Rimsha Khan, Shireen Hamid, Usama Rehman
ABSTRACT
Introduction: Fine needle aspiration cytology (FNAC) is a well-known and valued technique for estimation of palpable breast masses before any surgery because it is highly sensitive, accurate, specific, and cheap. However, many surgeons and oncologists prefer core needle biopsy in comparison to FNAC for diagnosis.
Objective: The present study aims to evaluate the diagnostic accuracy of preoperative FNAC in detecting malignancy in primary breast cancer.
Methods: A total of 219 cases were included based on inclusion and exclusion criteria. FNA was done using a 23-gauge needle and results were interpreted by pathologists for adequacy and cellularity. Final cytological diagnoses were categorized as per International Academy of Cytology (IAC) Yokohama Breast FNAC Reporting system. Comparison with histopathology was done. All the information collected was analyzed using SPSS version-24.
Results: Benign lesions (C2, C3) are most frequent in women aged 21–50 years. While malignant lesions (C4, C5) are heavily concentrated in the >50 age group, a significant number (48/87) were still seen in women’s reproductive years (21–50), suggesting early- onset cancers.. FNAC demonstrated a sensitivity of 87.8%, correctly identifying 86 out of 98 malignant cases, and a specificity of 100%, accurately classifying 120 out of 121 benign cases. These results underscore FNAC’s high diagnostic reliability, particularly in ruling out benign lesions. On comparing the cyto categories with the histo categories, the chi-square test result statistically supports this association. With p-value < 0.0001, the results reflect a highly significant association between cytology and histological findings.
Conclusion: : FNAC is a highly accurate and dependable first-line diagnostic tool for breast lesions.
Keywords: Cytopathology, Fine Needle Aspiration Cytology (FNAC), National Health Services Breast Screening Program