scholarly journals The diagnosis of malignant breast lumps using fine needle aspiration cytology and ultrasonography versus histopathology

2021 ◽  
Vol 25 (1) ◽  
pp. 423-430
Author(s):  
Ahmed Baban

Background and objective: The most common cancer of women worldwide is breast cancer and usually presents as a breast lump. Fine needle aspiration cytology and ultrasonography are two investigational techniques used to differentiate malignant breast lump from benign one. This study aimed to find out and compare the specificity, sensitivity, and predictive values of ultrasonography versus fine needle aspiration cytology for the diagnosis of malignant breast lump. Methods: Patients who presented with clinically palpable breast lump at the department of Surgery, Rizgary Teaching Hospital, Erbil, from October 2014 to March 2016, were included. The age of the study participants ranged from 15 to 56 years. The highest rate (28.9%) was among the age group 35-45 years. Breast abscess, cystic breast lumps, and recurrent lumps have been excluded. The ultrasonographic evaluation was done by using 7.5 MHz probe for all patients at the department of radiology and fine needle aspiration cytology at the department of histopathology. All the patients underwent excision of the lumps, and histopathological examination was done for tissues. Specificity, sensitivity, and predictive values of ultrasonography and fine needle aspiration cytology were estimated, taking the histopathological result as the gold standard. A comparison of values was made. Results: Ninety patients with 93 breast lumps were included in this study. Fine needle aspiration cytology reported 28 lumps as malignant lumps and 63 as benign, and two cases were indeterminate. Ultrasonography reported 27 cases as malignant, 54 as benign, and nine as indeterminate, while three breast lumps were failed to be detected. Sensitivity, specificity, positive and negative predictive values of ultrasonography and fine needle aspiration cytology in diagnosing malignant breast lump were 94.74%, 100%, 100%, 97.22%, and 90.48%, 100%, 100%, 95.24%,respectively. Conclusion: Ultrasonography and fine needle aspiration cytology are 100% specific in diagnosing malignant breast lesions. Although ultrasonography appears more sensitive than fine needle aspiration cytology, it has a higher percentage of the indeterminate report. Keywords: Fine needle aspiration cytology; Ultrasonography; Breast lumps.

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 780-786
Author(s):  
Shaheen Akter ◽  
Md Jahidul Islam ◽  
Md Shariful Haque

Background: With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lumps has been revolutionized and it has high sensitivity and specificity.Aim: In this study we analyze the spectrum of FNAC diagnoses in breast lumps and compare the diagnostic accuracy of fine FNAC in differentiating the benign and malignant lesions of breast lumps with histopathological correlation.Materials & Methods: Two years prospective study was conducted in our institution and in that 490 aspirations, including 6 bilateral were performed. Suppurative and inflammatory lesions were excluded from the total aspirates. The cytological diagnosis was classified into 3 groups benign, suspicious and malignant. After this reporting all the available 94 cases were later subjected to mastectomy or open/excision biopsy and followed-up by histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology.Results: A total of 490 FNAC cases were reported including 373 as benign, 4 as suspicious for carcinoma and 113 as carcinoma. Majorities were premenopausal females and commonest age group was 31-40 years. Among them only 94 cases were followed-up by histopathologic confirmation. In histopathological correlation study, we had accuracy rate of 100% for benign lesion and 92.10% for malignant lesion with false negative rate of 7.90% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 92.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 94.91%.Conclusion: FNAC in experienced hands is a very useful tool with very high specificity and rare false positive result. Sensitivity can be further improved with clinical and imaging correlation.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 780-786


2014 ◽  
Vol 2 (2) ◽  
pp. 40-43 ◽  
Author(s):  
Adnan Khan ◽  
Raza Jamali ◽  
Muneeb Jan ◽  
Maria Tasneem

Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods: This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar, Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four  cases with breast lumps were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3 lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology.  In this study, FNAC and histopathology diagnoses were strongly correlated [r 0.92, p <0.001]. Conclusion: Diagnosis of breast lump based on FNAC should be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.


2014 ◽  
Vol 4 (8) ◽  
pp. 630-634
Author(s):  
MK Shrestha ◽  
D Ghartimagar ◽  
A Ghosh ◽  
E Shrestha ◽  
P Bolar

Background: Approximately 10% of breast masses are breast cancer. It is important for women with a breast lump to receive appropriate evaluation. Mammography has been the “gold standard” in breast cancer detection for >40 years. Ultrasonography is non-invasive easily available, cheaper and accurate tool while Fine needle aspiration cytology has a high diagnostic accuracy rate in hands of experienced cytopathologist. Materials and methods: This was a retrospective and prospective study of 173 women attending radiology department in Manipal Teaching Hospital, Pokhara for mammography during a period of 18 months from January 2011 to June 2012.The age ranged from 20yrs to 75yrs. BIRADS score was given for both mammography and sonomammography. All malignant and suspicious cases had undergone fine needle aspiration cytology. Cytology reports were correlated with imaging study. Results: The most common age group for the breast lump was 40-49 years showing 65(37.57%) cases. Most lumps were seen on the left side 54.3% (94/ 173) cases and were seen in upper outer quadrant of the breast (74 cases). 11 cases each were given the BIRADS score of 4 in both mammography and sonomammography. Sensitivity and specificity of mammography and sonomammography were compared to cytologyreports. The sensitivity for mammogram was 73.7% while specificity was 96.3%. The sensitivity and specificity for sonomammogram was 78.9% and 95% respectively. Conclusion: Quadruple assessment i.e. clinical assessment, mammography, sonomammography and cytological study are the new “gold standard” in the investigation of breast disease. DOI: http://dx.doi.org/10.3126/jpn.v4i8.11499 Journal of Pathology of Nepal; Vol.4,No. 8 (2014) 630-634


2017 ◽  
Vol 20 (6) ◽  
pp. 544-553 ◽  
Author(s):  
Camille A McAloney ◽  
Leslie C Sharkey ◽  
Daniel A Feeney ◽  
Davis M Seelig

Objectives The primary objective of this study was to retrospectively assess the diagnostic utility of feline renal fine-needle aspiration cytology by assessing diagnostic yield, cytologic characteristics and diagnostic accuracy. The secondary objective was to characterize ultrasonographic features of sampled kidneys to determine if they influenced diagnostic yield. Methods Slides, images and patient data were collected from the University of Minnesota Veterinary Medical Center database. Slides were designated as diagnostic or non-diagnostic. Non-diagnostic slides were used in calculating diagnostic yield and excluded from other analysis. Slides were evaluated for cytologic characteristics and assigned a single primary diagnosis. Ultrasound still images were evaluated for descriptive characteristics and characteristics of specific lesions were described. Cases with confirmatory testing were used to determine diagnostic sensitivity, specificity and positive and negative predictive values for detecting neoplasia. Results Of 96 cytologic submissions available for review, diagnostic yield was 68%; 48% of samples were at least moderately cellular. Of 87 cases with ultrasound data, kidneys showing subcapsular renal infiltrate, diffuse renal enlargement without pelvic dilation and infiltrative/nodular change were more likely to yield diagnostic samples. Of 12 confirmed cases, cytology was 100% sensitive and specific for the detection of neoplasia (four round-cell tumors and two carcinomas). Three cases with non-neoplastic histologic diagnoses were considered cytologically normal, two incorrectly diagnosed the pathology present, and one correctly diagnosed the pathology. While some imaging characteristics were more commonly seen in neoplastic vs non-neoplastic lesions, the sample size was insufficient for definitive correlation. Conclusions and relevance This is the first major analysis of feline ultrasound-guided renal fine-needle aspiration cytology. This technique generates adequate samples for interpretation at rates comparable to other soft tissues and is most useful in the diagnosis of neoplasia. Some imaging characteristics are indicative of the likelihood of obtaining an adequate sample for cytologic interpretation.


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