Study of Fine Needle Aspiration Cytology of Breast Lump: Correlation of Cytologically Malignant Cases with their Histological Findings

Abstract

Background: In Bangladesh a large number of patients have been suffering from breast cancer and with each passing year, the number is increasing.

Objectives: To correlate breast lesions diagnosed as cytologically malignant with their histological findings.

Methods: This is a prospective study carried out in the Department of Pathology, BSMMU, Dhaka during the period of January 2009 to December 2009. Patients with breast lump, having malignant breast lesions on cytology were included in the study. A total of 524 patients with breast lump underwent FNA examination for the diagnosis during this period. FNA slides were examined under light microscope after Papanicolaou staining and were categorized into five groups: i) inadequate ii) benign iii) atypical cells iv) suspicious for malignancy and v) malignant. Of these, 431 were diagnosed as benign, 4 as atypical, 17 were diagnosed as suspicious for malignancy and 72 cases were diagnosed as malignant. Out of these 72 cases, which were cytologically diagnosed as malignant, 55 corresponding surgical specimens (either mastectomy or lumpectomy specimens) were received for histopathology. The sections were stained with haematoxylin and eosin for microscopic examination.

Results: 55 cases which were diagnosed as malignant by FNAC were found to be malignant by histopathology. 54 (98.18%) were invasive ductal carcinoma (NOS) and one (1.82%) was mucinous carcinoma. In this study, considering only cases with a definitive diagnosis of malignancy, the sensitivity of FNAC to diagnose the disease was 100% and accuracy was 100% and Chi-square test revealed Chi-square value 10.83 (P< 0.001).

Conclusion: From the present study it is evident that FNAC is a simple and reliable method. No local anaesthesia is required. Operative risk of surgical biopsy, danger of post operative infection can be avoided by adopting the procedure. It helps to confirm the clinical impression without open biopsy.

Key words: Breast lump; FNAC; Mastectomy; Malignancy.

DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8631

BSMMU J 2011; 4(2):60-64