Abstract

Objective: For the diagnosis of breast lumps, Triple Assessment methods, which include clinical assessment, radiological imaging and pathological diagnosis is the most accepted Worldwide, in which FNAC is the most important methods of cytopathology diagnosis. The aim of present study was to evaluate the result of aspiration cytology of breast lump and to establish the diagnostic accuracy of the technique by comparative evaluation with histopathological diagnosis of respective breast lump.

Materials and Methods: Present study was conducted in the department of Pathology, Sri Krishna Medical College, Muzaffarpur, Bihar during the period of August 2015 to December 2016. A total of 76 Patients with breast lump attending the Gynaecological or surgical OPD and IPD were included in the study. After thorough clinical history, all the patients were subjected to proper clinical examination. Prior to F.N.A.C. all the relevant routine investigation (CBC, ESR, LFT, KFT, BT, CT, Blood Sugar, Viral Markers) were performed and written consent were taken.  Tight fitting 10 ml plastic disposable syringes with fine 22 Gauge needles of 38 mm length were used for FNAC. Specimens were immediately smeared on glass slides and air dried for May Grunwald Giemsa stain. Wet fixed smears were stained by Papanicolaou and H and E stains and seen under oil immersion lens. After FNAC every patient underwent a definitive surgical procedure for breast lump and after that all the tissue undergone histopathological examination. The results thus obtained from FNAC and histopathology was matched and a correlated.

Results:  In this study the maximum number of 34 (44.73%) cases were belong to the age group of 21-30 years followed by age group of 31-40 years in which there were 16 (21.05%) cases, while the minimum incidence of 4 (5.26%) cases were in the age group of 51 years and above. Out of 76 patients a total of 62 patients (81.75%) were diagnosed as benign breast lesion (Fibroadenoma 44.73%, Fibroadenosis 21.05%, Mastitis 15.75%), malignant  lesion in  08(10.52%), suspicious or atypical  lesion  in 05 cases (6.57%) by FNAC and 01(1.31%) cases had scanty aspirates. Out of 76 cases studied, 10 cases were histologically confirmed cases of carcinoma. Remaining 66 cases were of benign lesions, of which there were 37 cases of fibroadenoma, 17 cases of fibroadenosis and 12 cases of chronic mastitis. 10 cases of carcinoma and 66 cases of benign breast lesions were diagnosed correctly by fine needle aspiration cytology. The accuracy rate in diagnosing fibroadenoma and fibroadenosis was 91.89% and 94.11% respectively. Thus overall diagnostic accuracy rate found to be 91.5%.

Conclusion: FNAC of breast is simple, safe, cheap, and easy to perform, without anaesthesia, less traumatic and OPD procedure for diagnosis of breast lump. FNAC can provide a preoperative diagnosis with reasonable accuracy as compare to histology and gives guidelines to management In advanced carcinoma. 

Keywords: FNAC, breast lump, neoplasm, histopathology.