BACKGROUND

A method of definitive diagnosis of patients who present with palpable breast lump at  the  outpatient  clinic  is  needed  now a days.  This  method must be accurate, easy  to  perform  and    acceptable  to  the  patient,  can  be  carried out  in  a  busy  clinic setting and must not require too much preparation or expensive equipment. This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology(FNAC)  in differentiating the benign and malignant lesions of palpable breast lump with  histopathological  correlation  .

Methodology

One year prospective study from June 2015 to July 2016 involving 75 cases of women presenting in Surgery outpatient department, Government Dharmapuri  Medical College Hospital with complaints of lump breast. Patients  underwent  FNAC  of  the  palpable  breast  lump  after  thorough  physical examination.  The  cytological  report  was  described  as  benign,  suspicious  and malignant. Patient was informed about the report and proceeded with lumpectomy or mastectomy and histopathological  confirmation.  Later  diagnostic  accuracy  of  cytology reporting was  compared   with that  of histopathology. 

Results

FNAC had a  diagnostic accuracy of 100% for patient with benign breast  lesions  and 93.55% for   malignant  breast lesions. The sensitivity of FNAC in  diagnosing patients presenting with lump in breast was  100%.The specificity  was  93.55%. The positive  predictive value of 95.65%. The negative predictive value for FNAC was  100%.

K–coefficient–– 1.001068 which implies FNAC as a screening test and its results are comparable with the gold standard histopathological examination.

Conclusion

 The FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) is an essential and important test in diagnosing   and managing   patient presenting with lump breast.  It is   patient friendly, easy to perform, more reliable, repeatable and a simple test to diagnose patient presenting with lump breast.  The accuracy of diagnosis increase if FNAC is performed and slides smeared and reported by an expert.    High  sensitivity  and    high  positive predictive value shows  that a patient with  positive FNAC  means a definite and accurate diagnosis of  the  concerned  pathology  when compared  with  the  final  histopathology  report.  The high specificity and a high negative predictive value of FNAC for malignancy showed the high accuracy  of FNAC in the  diagnosing  malignancy. Thus, we conclude that FNAC is an important and essential preliminary test in diagnosing a patient presenting with breast lump and proceed with appropriate surgical management and it shows high degree of correlation with the final histopathological report. From  our  results,  it  can  be  advised  that  the  patients  in  which  FNAC  is unequivocally  diagnostic  for  cancer  can  be  managed  directly  by  mastectomy  or any  other  definitive  therapy