Comparison between histopathology and fine needle aspiration cytology in the case of breast lumps

Anam Malik; Naveed  Islam; Abeer; Maliha  Asif; Imrana  Shaukat; Madiha  Iqbal

doi:10.36283/ziun-pjmd14-4/027

Authors

Anam Malik Nishtar Medical University, Multan.
Naveed Islam Nishtar Medical University, Multan.
Abeer Services Institute of Medical Sciences / Services Hospital, Lahore.
Maliha Asif Rahbar Medical & Dental College, Lahore.
Imrana Shaukat Nishtar Medical University, Multan.
Madiha Iqbal Fatima Jinnah Medical University, Lahore.

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/027

Keywords:

FNAC, Histopathology, Breast lump, Diagnostic accuracy, Sensitivity

Abstract

Objective: To determine the diagnostic accuracy fine needle aspiration cytology in cases of breast lump taking histopathology as gold standard.

Methodology: This study was a comparative, observational study conducted at Multan Institute of Nuclear Medicine and Radiotherapy (MINAR) from January 2024 to December 2024. This study was evaluated the diagnostic accuracy of fine needle aspiration cytology (FNAC) in comparison to histopathology for the diagnosis of breast lumps. The results of FNAC and histopathology were recorded and compared. The statistical calculation was done using SPSS 24 version. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of FNAC were calculated using histopathology as the gold standard.

Results: The study included 51 women with an average age of 45.94±9.58 years. Histopathology and fine needle aspiration cytology (FNAC) were used for diagnosis. FNAC diagnosed 100% as fibroadenoma, and histopathology confirmed all 28 cases, but 11.8% initially classified as fibroadenoma were later found to be malignant. FNAC correctly identified 88.2% as malignant, with all confirmed by histopathology. FNAC also diagnosed 100% as benign phyllodes, and all were confirmed by histopathology.

Conclusion: FNAC is a reliable and fast diagnostic method for breast lumps. It has an 88.2% diagnostic accuracy for malignant and 100% for benign phyllodes. It is accurate with manageable complications. The procedure is outpatient-based, reducing hospital stays. Its quick turnaround makes it useful for early diagnosis.

Author Biographies

Anam Malik, Nishtar Medical University, Multan.

Department of Histopathology
Naveed Islam, Nishtar Medical University, Multan.

Department of Pathology
Abeer, Services Institute of Medical Sciences / Services Hospital, Lahore.

Department of Pathology.
Maliha Asif, Rahbar Medical & Dental College, Lahore.

Department of Haematology.
Imrana Shaukat, Nishtar Medical University, Multan.

Department of Pathology.
Madiha Iqbal, Fatima Jinnah Medical University, Lahore.

Department of Histopathology.

References

1. Zaheer S, Yasmeen F. Historical trends in breast cancer presentation among women in Pakistan from join-point regression analysis. Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):134-139.

2. Hussain I, Majeed A, Masood I, Ashraf W, Imran I, Saeed H, et al. (2022) A national survey to assess breast cancer awareness among the female university students of Pakistan. PLoS ONE 17(1): e0262030.

3. Menhas R, Umer S. Breast Cancer among Pakistani Women. Iran J Public Health. 2015 Apr;44(4):586-7.

4. Ali MT, Abdullah SN. Comparison of Fine Needle Aspiration and Core Needle Biopsy in Diagnosis of Granulomatous Mastitis Presenting with Breast Lump. Saudi J Pathol Microbiol. 2024;9(5):87-92.

5. Kulkarni SS, Murchite S, Patil A. A comparative study between fine needle aspiration cytology and core needle biopsy in the diagnosis of palpable breast lumps. Journal of Surgery and Research. 2022;5(2):221-8.

6. Verma P, Sharma R, Sharma N, Gulati A, Parashar A, Kaundal A. Fine-needle aspiration cytology versus core-needle biopsy for breast lesions: a dilemma of superiority between the two. Acta Cytologica. 2021 Sep 3;65(5):411-6.

7. Ahmed I, Bharti S. Histological Correlation Of All Palpable Breast Lumps Using Fine Needle Aspiration Cytology. Innovative Journal of Medical and Healthcare Research. 2024:26-43.

8. Reddy R, Prabhala S, Somalwar SB, Deshpande AK. Evaluation of Breast, Lymph Node, and Thyroid Fine Needle Aspiration Cytology by Liquid Based Smears and Conventional Smears. Journal of Experimental Pathology. 2024 Feb 7;4(1):34-44.

9. Taye E, Ali MM, Toma A, Teklehaimanot A. Comparison of Fine Needle Aspiration Cytology and Histopathology in the diagnosis of lymph node pathologies at health facilities located in Hawassa: A 5-year retrospective study. SAGE Open Medicine. 2022 Dec;10:20503121221138324.

10. Agrawal N, Kothari K, Tummidi S, Sood P, Agnihotri M, Shah V. Fine-needle aspiration biopsy cytopathology of breast lesions using the International Academy of Cytology Yokohama System and rapid on-site evaluation: a single-institute experience. Acta Cytologica. 2021 Nov 4;65(6):463-77.

11. Jindal U, Singh K, Kochhar A. Fine needle aspiration cytology of breast lumps with histopathological correlation: A Four Year and eight-month study from rural India. Internet J Pathol. 2012;13(3):20-4.

12. Khemka A, Chakrabarti N, Shah S, Patel V. Palpable breast lumps: Fine-needle aspiration cytology versus histopathology: A correlation of diagnostic accuracy. Internet J Surg. 2009 Dec 1;18(1):1-25.

13. Jan Y, Hussain S, Waqas , Shah M, Din A, Khan A. Comparison of Fine Needle Aspiration Cytology (FNAC) and Trucut biopsy in evaluation of suspicious palpable breast lesions. RMJ. (2016), [cited January 21, 2025]; 41(2): 205-208.

14. Dikshit R, Gupta PC, Ramasundarahettige C, Gajalakshmi V, Aleksandrowicz L, Badwe R, Kumar R, Roy S, Suraweera W, Bray F, Mallath M, Singh PK, Sinha DN, Shet AS, Gelband H, Jha P; Million Death Study Collaborators. Cancer mortality in India: a nationally representative survey. Lancet. 2012 May 12;379(9828):1807-16.

15. Ibikunle DE, Omotayo JA, Ariyibi OO. Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: a five-year review. Ghana Med J. 2017 Mar;51(1):1-5.

16. Tripathi K, Yadav R, Maurya SK. A Comparative Study Between Fine-Needle Aspiration Cytology and Core Needle Biopsy in Diagnosing Clinically Palpable Breast Lumps. Cureus. 2022 Aug 5;14(8):e27709.

17. Hirachand S, Lakhey M, Akthar J, Ghimire R, Dhakhwan R. Comparison of FNAC and open biopsy in palpable breast lumps. Health renaissance. 2010;7(1):9–12.

18. Kumar PSK, Mahesh GS. Clinical Profile and Correlation between FNAC and Histopathology of Breast Lumps in a Teaching Hospital. Glob J Med Res. 2014;14:2.

19. Vishnu VK, Ashwini RK, Rajagopalan S. Comparison between histopathology and fine needle aspiration cytology in the case of breast lumps. Int Surg J 2019;6:4095-7.

20. Abdel-Hadi M, Abdel-Hamid GF, Abdel-Razek N, Fawzy RK. Should fine-needle aspiration cytology be the first choice diagnostic modality for the assessment of all nonpalpable breast lesions? The experience of a breast cancer screening center in Alexandria, Egypt. Diagn Cytopathol. 2010;38(12):880–889.