The value of systematic pattern analysis in FNAC of breast lesions: 225 cases with cytohistological correlation

Abstract

Background:Fine needle aspiration cytology (FNAC) has a high rating in the assessment of breast lesions. Various methods have been used to diagnose cytology of breast lesions.Aims:Present study was undertaken to evaluate the feasibility of application of systematic pattern analysis based on morphology in diagnosing breast aspirates.Materials and Methods:This is a retrospective study of FNAC of the breast done over a period of 4 years in a tertiary care centre. A total of 225 cases of breast lesions for which FNAC was done with histological follow-up were included in the study. Breast aspirates were provisionally diagnosed based on systematic pattern analysis. Aspirates were grouped into six categories based on predominant cellular pattern, and correlation between cytological and histological diagnosis was assessed.Results:Application of pattern analysis on FNAC of breast lesions in our study had a sensitivity of 94.5%, specificity of 98%, diagnostic accuracy of 97%, positive predictive value of 95.8%, and negative predictive value of 97.4%.Conclusions:Systematic pattern analysis based on morphology of FNAC smears was found to be highly reliable and could be easily reproducible in the assessment of breast masses.

Cytomorphological Study of Spectrum of Breast Lesions and Determination of Efficacy of Fnac in the Diagnosis of Various Breast Lesions

“…The mean age for malignant cases was 43.24±14.45 years. [1,2,3,4,5,8,9,11,12,13] In the present study, 90 cases were positive for malignancy (17.5%). 04 cases (0.78%) were categorized into Atypical Ductal Hyperplasia (ADH)/Ductal Carcinoma in Situ (DCIS) and 05 cases were classified as suspicious of malignancy (0.97%).…”

“…It is less traumatic and provides immediate report to the patient and therefore is a widely accepted method of analyzing various breast lesions. [2,4,5,6,7,8,9] Proof of malignancy is the usual aim of such a procedure although it can be used for diagnosis of benign lesions as well as some inflammatory conditions. [5,7,8] The present study comprised of 529 aspirations performed on 512 patients.…”

“…Similar results regarding the percentage of cases positive for malignancy have been reported in various other studies. [1,2,4,5,9,11,12,13,14] 38 of 90 cases classified as malignant showed enlarged and palpable axillary lymph nodes. 09 (10%) of these cases showed metastatic deposits whereas 29 (32.2%) showed reactive changes.…”

“…These findings are in accordance with other studies, which showed similar results. [1,2,4,5,9,11,12,13,14] Inflammatory lesions accounted for 65 cases (12.7%), which included 40 cases of abscess, 20 cases of granulomatous mastitis and 05 cases of chronic mastitis. All 20 cases of granulomatous mastitis were non-caseating and ZN stain for acid-fast bacilli (AFB) was negative.…”

Evaluation of Breast Lump by Fine Needle Aspiration Cytology

“…There were no false positive cases while false negative cases accounted for 14.3%. These findings are similar to other studies 2,12,13 . The FNAC results are more reliable regarding malignant lesions; however the category of "suspicious for malignant lesions" needs histopathological evaluation before performing surgical measures 7 .…”