Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

Abstract

To determine the pattern of disease in patients presenting with breast lumps and to determine the sensitivityand specificity of fine needle aspiration cytology of benign and malignant diseases as a diagnostic tool by correlatingwith histopathology findings. This retrospective study was carried out in the Department of Pathology, MaharajaAgrasen Medical College, Agroha, from Jan 2008 to April 2012. Fine needle aspiration cytology was performedon 370 cases and out of these 52 cases were received in the Department for histopathological examination.Fibroadenoma was the most common disease encountered, in 88 (24%), with a peak incidence in second andthird decade of life. Fibrocystic disease was second, being common in the third and fourth decades of life. Peakincidences of duct ectasia, granulomatous and tubercular mastitis were seen in the third decade. Gynaecomastiashowed two peak incidences in second and sixth decades of life . Out of total 370 cases undergoing fine needleaspiration, benign cases were 316 (85.4%), malignant and suspicious were 54 (14.6%) and 10 (2.70%) respectively.Out of total 22 histological confirmed malignant lesions 19 were interpreted as malignant cytologically whiletwo as suspicious and one as benign. All thirty histologically confirmed benign cases were diagnosed as benigncytologically. The sensitivity, specificity, positive and negative predictive values were 98%, 100%, 100% and96.4% respectively. FNA cytology is highly accurate for diagnosis of breast masses. However, the clinician shouldcorrelate FNA cytological results with physical examination and imaging findings to prevent false negative andfalse positive events and to obtain optimal management of their patients.