A comparative analysis of mammography breast imaging reporting and data system score and fine needle aspiration cytology in the evaluation of palpable breast lump

Abstract

Background: Breast lump is one of the commonest complaints with which patients present in breast clinics. As in most cases breast lump ultimately leads to a diagnosis of breast cancer, it is important for women with a breast lump to receive appropriate evaluation. So initial diagnostic approach such as utilization of rapid, inexpensive, presumptive and safe method is utmost important as such methods not only would benefit both patients and clinicians by prompting proper preoperative diagnosis and management but also further limits unnecessary testing and procedures. Aim and objectives of this study was to analyse the diagnostic accuracy of mammogram according to Breast Imaging Reporting and Data System (BI-RADS) score and fine-needle aspiration cytology (FNAC) in patients presented with benign and malignant breast lumps in authors centre.Methods: During this retrospective study from January 2018 to December 2018, the subjects concerned included all the female patients, who were referred to the department of pathology for FNAC of their breast mass and had radiological reports (mammography) with BI-RADS score according to the latest guidelines. The sensitivity, specificity, accuracy, positive and negative predictive values of BI-RADS scores and FNAC in diagnosis of breast diseases was done on the basis of final diagnosis.Results: In this study, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 88.57%, 82.46%,75.61%,92.16% and 84.78%, respectively for Mammography (BIRADS) score and 100% for all the parameters on FNAC.Conclusions: According to authors above study findings concluded that FNAC could be considered an ideal initial diagnostic modality in all breast lumps recognized by means of imaging techniques. It is not only considered as safe, cost effective, rapid and presumptive diagnostic method but also further limits unnecessary testing and procedures.

Correlation between bi-rads categories and cytological findings of breast lesions

“…presentation in our study was painless and mobile breast lump(92%) which was comparable with other study by Ken Munene Nkonge et al [13] (96%). b) Cytomorphological findings  In present study, out of 100 cases, benign breast lesions (55%) were more common than malignant breast lesions (45%) which was comparable with other studies: by Arpita Pandia et al [10] 55.43% & 38% cases reported as a benign & malignant respectively, by Ramesh S. Waghmare et al [14] 56.25% & 31.50% cases reported as a benign & malignant respectively and by Anto J. Richie [7] . 57.5% & 42.5% cases reported as a benign & malignant respectively.…”

“…a) Clinical presentation: 1. Incidence of Age: In our study, Out of 100 cases, maximum number of cases (29%) were between 41 to 50 years of age group which was correlated with other study: by Arpita Pandia et al [10] maximum number of cases (28%) were between 40-50 years of age group.…”

“… In present study, on FNAC findings there were 2 false negative cases which were diagnosed as malignant lesion by histopathology in which one case of atypical ductal hyperplasia diagnosed as ductal carcinoma and ~ 48 ~ one case of benign phyllodes tumor diagnosed as malignant phyllodes tumor. The other studies: by Rahman MZ et al [15] with 1 false negative cases and by Arpita Pandia et al [10] with 2 false negative cases.  In present study, FNAC showed 98% sensitivity which was comparable with other studies: by Rahman et al [15] with 97.2% sensitivity, by Bukhari et al [17] with 98% sensitivity and by Panjvani SI et al [18] with 97.82% sensitivity.…”

“…In malignant category, 4 cases were diagnosed as suspicious for malignancy due to low cellularity, subtle atypia or obscuring background. [10] showed 10 false positive cases and 4 false negative cases and by Rahman MZ et al [15] showed 8 false positive cases and 5 false negative cases.  In present study, mammosonogram showed 91% sensitivity which was comparable with other studies: by Bak et al [16] with 91% sensitivity and by Arpita Pandia et al [10] with 88.57% sensitivity.…”

A Comparative Analysis of Fnac and Birads in Evaluation of Palpable Breast Lump

“…In this study maximum numbers of patients with benign diagnosis were in 31-40 years age and majority of malignant cases were in the 41-50. This finding was consistent with the [11] previous study done by Garg et al . In our present study, out of 80 cases, benign breast lesions (67.5%) were more common than malignant breast lesions (32.5%) which was comparable with other studies by Arpita [12] Pandia et al which reported 55.43% & 38% cases reported as a benign & malignant respectively. In a study by Ramesh S. [14] study by Anto J. Richie .…”