Incidence of breast malignancies has been rising. Any breast lump needs to differentiated as surgery may not be required in all cases. The National Health Services Breast Screening Program recommends Fine Needle aspiration cytology (FNAC) as a non-operative diagnostic tool. FNAC is a cheap, readily available, relatively painless, repeatable and patient-friendly investigation with good sensitivity and specificity. FNAC does not yield a tissue diagnosis as opposed to core biopsy, however, a well-performed FNAC and reporting by an expert pathologist help to avoid unnecessary surgeries in benign lesions where only conservative management or elective surgery is needed. Aims: To study the correlation between FNAC and histopathological reports of palpable breast lumps. Materials and method: We conducted an observational study at a tertiary care hospital. The study included 237 patients of palpable breast lumps who had undergone FNAC, excisional biopsy and histopathology in the same institution. The results of FNAC and histopathology reports were correlated into benign and malignant categories. Results: There were 225 women and 12 men in this study. FNAC had reported 20 malignant (C4+C5) cases and 217 benign cases. Histopathology revealed 21 malignant cases and 216 benign cases. We observed a sensitivity of 90.48%, specificity of 99.54%, a positive predictive value of 95%, a negative predictive value of 99.08%, a concordance of 92.41%, a diagnostic accuracy of 98.73% and a negative likelihood ratio of 0.1 for FNAC. Conclusions: Besides other advantages, FNAC of a breast lesion is reliable enough to rule out malignancy.
Utility of ultrasound guided versus conventional fine needle aspiration cytology in diagnosing breast malignancies among patients with palpable breast lumps at Bugando Medical Centre, Mwanza Tanzania
