PALPABLE BREAST MASSES AT THE UNIVERSITY OF PORT HARCOURT TEACHING HOSPITAL; FINE NEEDLE ASPIRATION CYTOLOGY VERSUS HISTOPATHOLOGY: A CORRELATION OF DIAGNOSTIC ACCURACY

Abstract

Objective:
To establish the diagnostic accuracy of FNAC for palpable breast lesions by
comparing their findings with histological findings from excision biopsy or
mastectomy specimen.
Materials and methods:
This comparative study was conducted in the Department of Anatomic
Pathology, University of Port-Harcourt Teaching Hospital, Port-Harcourt, Rivers
State, from September 2013 to August 2014. All patients with palpable breast
lesions who consented and had FNAC of their breast lump at the FNAC clinic of
Anatomical Pathology department and subsequent biopsy or mastectomy at
the General Surgery department of the University of Port-Harcourt Teaching
Hospital were recruited for the study.
Results:
A total of 100 consecutive FNAC findings compared and correlated with the
corresponding histologic findings of the same lesions.
On cytodiagnosis, fourteen (14%) patients had inadequate sample. Fifty two
(52%) patients had C2 lesions. Two cases (2%) were reported as having C3
lesions and also four other cases as C4 lesions (4%).
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Twenty eight patients (28%) had C5 lesion; five of these patients had
mastectomy.
The histopathologic diagnosis shows 67 (67%) benign lesions. The remaining 33
cases (33%) were diagnosed as carcinoma of the breast on histopathology.
Fourteen cases reported as C1 lesions (14%) were reported on histology as
benign lesions (6 fibrocystic diseases, 4 fibroadenomas, 2 breast abscesses and
1 fat necrosis) but 1 invasive lobular carcinoma. A case was reported as C2
lesions (false negative) and excision biopsy was advised but it turned out to be
an invasive ductal carcinoma of the breast. The two cases which were
diagnosed as C3 lesions came out to be fibroadenomas.
There were four cases given as C4 (4%) lesions and three turned out to be
malignant on histopathology while one case was reported as fibroadenoma.
From this study, the absolute sensitivity of FNAC as a diagnostic tool in
palpable breast lesions is 84.9% and specificity of 98.2%. The complete
sensitivity of 93.9% and positive predictive value of malignant diagnosis of
100% was obtained.
Conclusion:
FNAC has good sensitivity and high specificity and it can be used as a routine
method for determining the nature of breast lumps.
Key words: FNAC, breast lump, breast cancer