The Role of Fine Needle Aspiration Cytology in the Diagnostic Evaluation of Palpable Breast Lesions Seen in a Low-resource Hospital Setting

Background: Preliminary diagnosis of palpable breast lesions often requires the use of fine needle aspiration cytology (FNAC). The aim of this study was, therefore, to determine the diagnostic utility of this procedure in the evaluation of palpable breast masses seen at our institution.

Methods: FNAC was performed on all patients who presented with palpable breast lesions over the period of one year. These were classified according to the United Kingdom National Health Services Breast Screening Programme (UKNHSBSP) and were compared with the corresponding histopathologic diagnosis in each case. The sensitivity, specificity, positive predictive value as well as negative predictive value were subsequently determined.

Results: A total of 164 cytological reports were obtained from 153 patients during the study period. The patients seen during the study period were between the ages of 15-86 years (Mean 42.3±15.8 SD). The peak age range of presentation of benign lesions was 20-29 years while that for malignant was 40-49 years. Fifty (50.6%) were reported as benign (C2) and 31.7% were reported as malignant (C5). About 7.8% and 8.5% were reported as inadequate (C1) and suspicious for malignancy (C4) respectively. Histopathology was performed on 87 (biopsy rate of 53.0%). There was good correlation between the cytological and histological diagnosis with the sensitivity of FNAC for benign lesions being 97.3% while that for malignant lesions was 100%. The correlation between fine needle aspiration cytology of palpable breast lumps and histological diagnosis was found to be statistically significant.

Conclusion: FNAC of palpable breast lesions has a high predictive value for the histologic diagnosis especially when performed by experienced cytopathologists.