Comparison of accuracy of diagnostic modalities for evaluation of breast cancer with review of literature

Abstract

This study was conducted to confirm which of these modalities [mammography (MG), fine-needle aspiration cytology (FNAC), core-needle biopsy (CNB), or intraoperative touch imprint cytology (IOTIC)] is useful to detect breast cancer and to compare the accuracy of these modalities for the diagnostic setting. One hundred seventy-five, 85, 78, and 25 patients were selected who underwent FNAC, MG, IOTIC, and CNB, respectively. Histopathology was used as a gold standard for comparison of the results of all diagnostic modalities. Twenty-five patients with combinations of three preoperative tests (MG, FNAC, CNB) showed 100% accurate results when compared with histopathology, while the overall accuracy for MG, FNAC, and CNB was 91.7%, 91.5%, and 96%, respectively. Both touch and scrape imprints' sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy were 100% for class V and class II smears, while sensitivity, accuracy, and NPV were 87, 95, and 83% for IOTIC and 94%, 96%, and 89% for IOSC for class III and IV smears. On comparison of the results of all these procedures, the difference was nonspecific (P = 0.2, 0.3, 0.5, 0.55, and 0.6 for MG, FNAC, IOTI, IOSC, and CNB, respectively). Combinations of preoperative tests (MG, FNAC, CNB) were more accurate, reliable, and acceptable when compared with individual diagnostic procedure, but these have their own technical limitations. The accuracy of CNB was much higher than that of MG and FNAC. IOTP and IOSC are simple and cost effective diagnostic tests with better accuracy that can be used as an alternate to frozen section in diagnostic settings and margin assessments.

Fine Needle Aspiration Cytology of Palpable Breast Lump: A Study of 1778 Cases

“…Pradhan and Dhakal [17] also reported 15.5% malignant cases among their 2246 cases which are close to our study. Though Yip et al [20] and Bukhari and Akhter [21] found near results but their numbers of cases were relatively smaller, 676 and 175 respectively. Ahmed et al [7] in Sudan, Mayun et al [18] in Nigeria and Bukhari et al [8] in Pakistan reported 30.5%, 40% and 31% malignant cases which reflects less awareness of women to attend health facilities with smaller However, reports from the western world show that female breast carcinoma is predominantly seen in the fifth and sixth decade [29][30][31].…”

“…They needed core biopsy for confirmation of malignancy. Bukhari and Akhtar [21] and Bukhari et al [8] found 11.42 % and 8.4% suspicious cell for malignancy respectively. 139 (9%) cases were atypical/suspicious for malignancy reported by Rosa et al [22] and 51 (3.3%) atypical by Yeoh and Chan [23].…”

Disease-specific gene repositioning in breast cancer

“…In addition, we identified several combinations of two or three multiplexed markers that detect cancerous tissues with no false negative signals and a low rate of false positive outcomes. The false detection rate of this approach compares favorably to the current, standard breast cancer diagnostic tests, such as fine-needle aspiration cytology and core-needle biopsy cytology, for which false positive rates of 0-44% and 0-13.4%, respectively, and false negative rates of 1.3-39% and 4.5-17%, respectively, have been described (Arisio et al, 1998;Young et al, 2002;Chaiwun and Thorner, 2007;Ciatto et al, 2007;Bukhari and Akhtar, 2009); however, these rates, in contrast to our analysis, also include specimen sampling errors. Importantly, however, the broad range in false detection rates in conventional cytological assays is also largely related to the experience of the examining cytopathologist.…”

Diagnostic Value of Fine Needle Aspiration Cytology for Breast Tumors

“…Breast cancer survival rates tend to be poorer in developing countries, most likely because of a combination of late diagnosis and limited access to timely and appropriate treatment 1 . Th e accuracy of diagnosis can be increased with a combination of clinical examination, imaging diagnostics, and fi ne needle aspiration cytology (FNAC) or core needle biopsy, also known as triple test 2 . FNAC is a minimally invasive, simple, cost-eff ective, safe and sensitive method for breast tumor diagnosis 3 .…”