EFFICACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF BREAST LUMPS

Objective: To determine the sensitivity and specificity of fine needle aspiration cytology (FNAC), by comparing the results with excision biopsy..Material and Methods: This observational and comparative study was conducted in Surgical B Ward of Khyber teaching hospital Peshawar, Pakistan from August2002 to May2003. A total of50 women, who had a clinically palpable breast lump were subjected to concurrent FNAC and excision biopsy.Results: Out of12 malignant lesions on excision biopsy, FNAC correctiy diagnosed 9, and 2 were diagnosed suspicious, and the remaining one was misdiagnosed as non malignant. S>o false negative being 1/12 (8.3%). Of38 benign cases on excision biopsy, FNAC diagnosed correctly duct ectasia 3, tuberculosis 2, andgalactocele 1, while out of22 fibroadenoma, FNAC diagnosed 20, and 2 were diagnosed as unsatisfactory. Ten cases diagnosed as fibrocystic disease on excision biopsy, FNAC picked only 6 cases correctly. The one case diagnosed on FNAC as fibrocystic disease, turned out to be malignant on histology. The remaining 4 cases of fibrocystic disease diagnosed on histopathology were either reported as unsatisfactory (3 cases) or suspicious (1 case) on FNAC. The sensitivity and specificity of FNAC was 91.66% and 96.96% respectively.Conclusion: Breast cytology was an effective and rapid method ofdiagnosis ofbreast diseases. It helps in deciding which patient needs early open biopsy. A negative cytology does not exclude the possibility of malignancy, as there was a false negative rate of8.3%.