Fine needle aspiration cytology in breast lump - its cytological spectrum and statistical correlation with histopathology

Abstract

Introduction: FNAC is a well-recognized method of investigation in breast lump and has high sensitivity and specificity. In this study we analyze the spectrum and efficacy of FNAC diagnoses in breast lump.  Material and method: It was a hospital based retrospective study conducted from the data retrieved in the Pathology department. All FNAC breast cases reported between July 2008 to Dec 2009 except “inadequate aspirate” cases were included in the study. Corresponding biopsy were correlated where available. Diagnostic tests with ROC curve were used to find out the efficacy of FNAC. Result: A total of 196 FNAC cases were reported including 152 as benign, 7 as suspicious for carcinoma and 37 as carcinoma. Majorities were premenopausal females and commonest age group was 31-40 years. 88% of lumps were less than 5 cm. In reliability analysis, we got an excellent agreement of FNAC and Biopsy with kappa value as 0.882 [88.2%] (p=0.0001).Sensitivity and specificity were 90.2% and 100% respectively. 95.1% of the area was under the ROC curve with p-value=0.0001. Positive predictive value is 100% but the Negative predictive value varies according to the age and size. Conclusion: FNAC in experienced hands is a very useful tool with very high specificity and rare false positive result. Sensitivity can be further improved with clinical correlation.