scholarly journals Cytopathological Patterns of Palpable Breast Lumps on Fine Needle Aspiration - A Hospital Based Study

2021 ◽  
Vol 8 (06) ◽  
pp. 319-326
Author(s):  
Dharmakanta Kumbhakar ◽  
Partha Pratim Talukdar
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Malignant Neoplasms ◽  
Duct Carcinoma ◽  
Female Ratio ◽  
Fine Needle ◽  
Palpable Breast ◽  
Breast Lumps

BACKGROUND The breast is composed of both specialised epithelial cells and stroma. Both benign and malignant lesions can occur in the breast as a palpable lump. Fine needle aspiration cytology (FNAC) is a rapid, easy to perform, minimally invasive and low cost first line high-diagnostic accuracy test for cytopathological evaluation of palpable breast lump with minimum complications. METHODS The study was carried out to evaluate the cytopathological patterns of 2706 palpable breast lumps by fine needle aspiration (FNA) procedure and cytohistopathological correlation of the available biopsied palpable breast lumps of the study in the Pathology department of Tezpur Medical College and Hospital, Assam, for a period of three years from July 01, 2016 to June 30, 2019. RESULTS Out of 2706 palpable breast lumps in the study, FNA smears of 19 (0.70 %) were inadequate for cytopathological reporting. Out of the remaining 2687 palpable breast lumps where FNA was adequate for cytopathological reporting, female patients (n = 2594) comprised 96.54 % and male patients (n = 93) comprised 3.46 % with a male and female ratio of 1:27.9. Out of the 2687 palpable breast lumps, 2318 were benign breast diseases (86.27 %) and 369 were malignant neoplasms (13.73 %), with a benign and malignant ratio of 6.28:1. Out of the benign breast lumps, fibroadenoma breast was seen in 1228 (52.98 %) and of the malignant neoplasms, infiltrating duct carcinoma was seen in 341 (92.41 %). Cytohistopathological correlation showed 98.70 % sensitivity, 99.38 % specificity, 99.35 % positive predictive value, 98.76 % negative predictive value, and 99.04 % diagnostic accuracy. CONCLUSIONS FNAC has high sensitivity and specificity in cytopathological diagnosis of palpable breast lumps. Based on the accurate cytopathological diagnosis of the palpable breast lumps, patients with palpable breast lumps can be given adequate treatment. KEYWORDS Fibroadenoma, Gynaecomastia, Duct Papilloma, Infiltrative Duct Carcinoma, Medullary Carcinoma, Mucinous Carcinoma, Malignant Phyllodes

scholarly journals A CORRELATIONAL STUDY BETWEEN FINE NEEDLE ASPIRATION CYTOLOGY AND HISTOPATHOLOGY OF PALPABLE BREAST LUMPS

2021 ◽  
Vol 7 (4) ◽  
pp. 117-123
Author(s):  
Vilas P. Kulkarni ◽  
Abhijit S. Rayate ◽  
Cristine Ann Thomas ◽  
Nikhil R. Barhate ◽  
Gaurav J. Gaikwad ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Care Hospital ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

Incidence of breast malignancies has been rising. Any breast lump needs to differentiated as surgery may not be required in all cases. The National Health Services Breast Screening Program recommends Fine Needle aspiration cytology (FNAC) as a non-operative diagnostic tool. FNAC is a cheap, readily available, relatively painless, repeatable and patient-friendly investigation with good sensitivity and specificity. FNAC does not yield a tissue diagnosis as opposed to core biopsy, however, a well-performed FNAC and reporting by an expert pathologist help to avoid unnecessary surgeries in benign lesions where only conservative management or elective surgery is needed. Aims: To study the correlation between FNAC and histopathological reports of palpable breast lumps. Materials and method: We conducted an observational study at a tertiary care hospital. The study included 237 patients of palpable breast lumps who had undergone FNAC, excisional biopsy and histopathology in the same institution. The results of FNAC and histopathology reports were correlated into benign and malignant categories. Results: There were 225 women and 12 men in this study. FNAC had reported 20 malignant (C4+C5) cases and 217 benign cases. Histopathology revealed 21 malignant cases and 216 benign cases. We observed a sensitivity of 90.48%, specificity of 99.54%, a positive predictive value of 95%, a negative predictive value of 99.08%, a concordance of 92.41%, a diagnostic accuracy of 98.73% and a negative likelihood ratio of 0.1 for FNAC. Conclusions: Besides other advantages, FNAC of a breast lesion is reliable enough to rule out malignancy.

scholarly journals Utility of fine-needle aspiration cytology as a screening tool in diagnosis of breast lumps

2017 ◽  
Vol 4 (4) ◽  
pp. 1171
Author(s):  
Rajat Gupta ◽  
Deepika Dewan ◽  
Dinesh Kumar ◽  
Rameshwar Sharma
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Ductal Carcinoma ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

Background: Fine-needle aspiration cytology (FNAC) has proved to be a rapid, safe, cost effective and good screening or initial diagnostic tool for early diagnosis and management of palpable breast swellings. The present study was conducted to describe and categorize various breast lesions on FNAC. The study also aimed to find out the diagnostic accuracy of FNAC procedure.Methods: This study was carried out on 175 patients who presented with palpable breast swellings in Government Hospital Gandhi Nagar, Jammu, Jammu and Kashmir, India and subsequently referred to Pathology Department of Govt. Hospital Gandhi Nagar over a period of two years and eight months from January 2013 to September 2015. Lesions were categorized as per cytomorphological features obtained on FNAC. Histopathological correlation was done on 68 cases inclusive of all malignant cases.Results: 156 (89%) cases were categorized as benign and 19 cases (11%) as malignant on FNAC out of 175 cases. The most common benign lesion was fibro adenoma (41%) and the most common breast carcinoma was ductal carcinoma (65%). Sensitivity, specificity, positive predictive value, negative predictive value, LR+ and LR-  came out to be 85%, 95.8%, 89%, 93.8%, 20.4 and 0.15 respectively.Conclusions: FNAC is a good screening procedure for initial diagnosis of breast lumps. It is highly useful procedure in secondary care centres due to its cost effectiveness, rapid and safe nature.

scholarly journals Correlation between Fine-Needle Aspiration Cytology and Histology for Palpable Breast Masses in a Nigerian Tertiary Health Institution

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Adetola Olubunmi Daramola ◽  
Mosebolatan Olatokunboh Odubanjo ◽  
Fred John Obiajulu ◽  
Nzechukwu Zimudo Ikeri ◽  
Adekunbiola Aina Fehintola Banjo
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

Background. Management of breast lumps can be challenging in resource poor settings. Fine-needle aspiration cytology (FNAC) especially when used with cell block can help improve affordability for the patients.Objective. To determine the diagnostic accuracy of FNAC of palpable breast lesions within a 5-year period.Methods. The findings obtained from FNAC of palpable breast lumps seen at the FNAC clinic of our department from January 2007 to December 2011 were retrieved and correlated with findings on histology of excisional biopsies.Results. A total of 1790 patients had FNAC of breast lumps during the 5-year period; 436 of them subsequently had biopsies. Our results compare favourably with the measures of test performance of the UK NHS Breast Screening Programme shown in brackets: absolute sensitivity 95.4% (>70%), complete sensitivity 99.2% (>90%), full specificity 88.9% (>65%), positive predictive value 99.6% (>99%), false-negative rate 0.8% (<4%), false-positive rate 0.4% (<0.5%), inadequate rate 3.2% (<15%), and suspicious rate 10.2% (<15%).Conclusion. Breast FNACs compare very well with histology of excisional biopsies and in experienced hands are extremely useful in the management of breast lumps. Further studies assessing the diagnostic accuracy of FNAC and cell blocks in our setting are recommended.

scholarly journals Use of Fine-Needle Aspiration in the Evaluation of Breast Lumps

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Mulazim Hussain Bukhari ◽  
Madiha Arshad ◽  
Shahid Jamal ◽  
Shahida Niazi ◽  
Shahid Bashir ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
Ductal Carcinoma ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

Background. A study was designed to see the role of fine needle aspiration cytology (FNAC) in palpable breast lumps. Materials and Methods. Four hundred and twenty five (425) patients came to the Department of Pathology King Edward Medical University, Lahore in four years for FNAC of their palpable breast masses from June 2006 to June 2010. FNAC diagnosis was compared with histological diagnosis to see the accuracy of fine needle aspiration cytology for neoplastic lesions. Results. There were 271/425 benign, 120/425 malignant, and 32/425 suspicious smears. Inadequate samples were repeated twice or thrice, and the degree of success was improved with consecutive repeating approaches. The frequency of inadequacy declined from 86 to 18, and 2 for first, second and third attempts, respectively. The number of repeats increased the diagnostic accuracy of aspirates which is statistically significant (). Invasive ductal carcinoma was the most commonly reported lesion with maximum incidence in the 4th, 5th, and 6th decades followed by invasive lobular carcinoma and other malignant lesions. The sensitivity, specificity, accuracy, negative predictive value, and the positive predictive value of FNAC was 98%, 100%, 98%, 100%, and 97%, respectively. Conclusion. FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment serves as an important diagnostic modality.

scholarly journals Fine-needle aspiration biopsy for breast lesions: a comparison between two devices for obtaining cytological samples

2005 ◽  
Vol 123 (6) ◽  
pp. 271-276 ◽  
Author(s):  
Ruffo Freitas Júnior ◽  
Marise Amaral Rebouças Moreira ◽  
Gustavo Antônio de Souza ◽  
Ellen Hardy ◽  
Regis Resende Paulinelli
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Breast Lesions ◽  
Fine Needle ◽  
Vacuum Device ◽  
Needle Aspiration Biopsy ◽  
Breast Lumps

CONTEXT AND OBJECTIVE: Fine-needle aspiration biopsy has been accepted worldwide for breast lesions. However, some questions remain, including the appropriateness of the puncture method. The objective of this work was to compare aspirates obtained by the auto-vacuum device and by the syringe pistol holder. DESIGN AND SETTING: Randomized trial for validation of diagnostic method, at Hospital das Clínicas da Universidade Federal de Goiás and Hospital Araújo Jorge, Goiânia. METHODS: 351 patients presenting breast lumps underwent fine-needle aspiration biopsy, either with the auto-vacuum device or the syringe pistol holder. A single cytopathologist analyzed all of the cytology slides. The rates of insufficient material, cellularity, cell distortion and background hemorrhage were evaluated. RESULTS: The percentages of insufficient material were 16% and 22% (p = 0.18), for the auto-vacuum and pistol aspirates, respectively. Good cellularity was seen in 34% of auto-vacuum and 29% of pistol samples (p = 0.4). Cell distortion was seen in 31 and 26 cases, respectively (p = 0.7). Background hemorrhage occurred in 63 (35%) and 54 cases (31%) (p = 0.2), for auto-vacuum and pistol. The sensitivity was 88% and 86%; specificity 99% and 100%, positive predictive value 96% and 100%, negative predictive value 96% and 95% and total accuracy 76% and 75% for the auto-vacuum and pistol, respectively. CONCLUSION: The results obtained from the two fine-needle aspiration biopsy methods were equivalent. Therefore, the auto-vacuum device is a good option for obtaining aspirates for cytology.

scholarly journals Fine Needle Aspiration Cytology of Palpable Breast Lumps - Their Cytological Spectrum and Histopathological Correlation

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 780-786
Author(s):  
Shaheen Akter ◽  
Md Jahidul Islam ◽  
Md Shariful Haque
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Breast Lump ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Histopathological Correlation ◽  
Palpable Breast ◽  
Needle Aspiration Cytology ◽  
Breast Lumps

Background: With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lumps has been revolutionized and it has high sensitivity and specificity.Aim: In this study we analyze the spectrum of FNAC diagnoses in breast lumps and compare the diagnostic accuracy of fine FNAC in differentiating the benign and malignant lesions of breast lumps with histopathological correlation.Materials & Methods: Two years prospective study was conducted in our institution and in that 490 aspirations, including 6 bilateral were performed. Suppurative and inflammatory lesions were excluded from the total aspirates. The cytological diagnosis was classified into 3 groups benign, suspicious and malignant. After this reporting all the available 94 cases were later subjected to mastectomy or open/excision biopsy and followed-up by histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology.Results: A total of 490 FNAC cases were reported including 373 as benign, 4 as suspicious for carcinoma and 113 as carcinoma. Majorities were premenopausal females and commonest age group was 31-40 years. Among them only 94 cases were followed-up by histopathologic confirmation. In histopathological correlation study, we had accuracy rate of 100% for benign lesion and 92.10% for malignant lesion with false negative rate of 7.90% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 92.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 94.91%.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 and imaging correlation.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 780-786

scholarly journals Diagnostic value of fine needle aspiration biopsy in parotid gland neoplasm

2016 ◽  
Vol 2 (2) ◽  
pp. 56 ◽  
Author(s):  
Yakup Yegin ◽  
Mustafa Çelik ◽  
Burak Olgun ◽  
Baver Masallah Simsek ◽  
Fatma Tulin Kayhan
Keyword(s):  
Parotid Gland ◽  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Biopsy ◽  
Benign Lesion ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Histopathological Results

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The value of fine needle aspiration biopsy (FNAB) in the diagnosis of parotid masses remains unclear, considering current literature. The surgical procedure is not planned according to the FNAB results by the majority of the otorhinolaryngologists. Objectives of the study was to compare the results of FNAB and histopathological results in diagnosing malignancy and benign lesions of parotid gland and to determine the sensitivity, specificity and accuracy of FNAB.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> It is a retrospective clinical chart review study. </span>In total, 61 patients (28 females and 33 males; average age, 46.31±15.79 years; age range: 12-82 years) with parotid gland masses who underwent preoperative FNAB were included in this study. All patients underwent FNAB under ultrasound guidance following clinical examination. Histopathological results of the surgical specimens and preoperative results of FNAB were compared and, the sensitivity, specify, positive predictive value (PPV), negative predictive value (NPV), the diagnostic accuracy of FNAB was calculated. A P-value &lt;0.05 was considered to reflect statistical significance.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The specificity of FNAB was 100% and its sensitivity was 57.2%. Accuracy for benign lesion was 91.4%, accuracy for a malignancy was 42.8% and overall diagnostic accuracy was 92.0%, respectively. PPV for benign lesion was 91.4% and the NPV was 100%, respectively. PPV for malignancy was 100% and the NPV was 91.4%, respectively.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong><span lang="EN-US">We suggest that FNAB is a valid, safe, easy-to-use method for identifying of parotid gland neoplasms. We recommend FNAB for all potential surgical patients. In our opinion, good collaboration between the Otorhinolaryngologist and the pathologist provides the best results.</span></p>

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