Comparative study of core needle biopsy and fine needle aspiration cytology in palpable breast lumps: scenario in developing nations

Abstract

Objective: The purpose of this study was to evaluate the utility of core needle biopsy as a diagnostic tool for palpable breast lumps in developing countries as compared to fine needle aspiration cytology .Material and Method: all patients attending the surgery outpatient department with palpable breast lumps were subjected to fine needle aspiration cytology and core needle biopsy by the same operator in a single session. Fine needle aspiration cytology was performed by the standard technique. Core needle biopsy was done freehand using a 14G manual core biopsy needle. reporting categories of the two techniques were taken from the standard National Health Service Breast Screening Programme criteria and were compared with the final histopathology results.Results: a total of 107 patients underwent fine needle aspiration cytology and core needle biopsy simultaneously. Histopathology was available for 85 cases. Statistical analysis of fine needle aspiration cytology and core needle biopsy showed no significant difference between the diagnoses offered by core needle biopsy and histopathology while there was a significant difference between fine needle aspiration cytology and histopathology diagnoses. Conclusion:Core needle biopsy detected more breast carcinomas as compared to fine needle aspiration cytology with a sensitivity 95.83% as opposed to 64.58%. Though both the techniques were equally specific (100%), Core needle biopsy was able to correctly categorize borderline / inadequate lesions into definitely benign and malignant categories. We suggest that core needle biopsy should be preferred over fine needle aspiration cytology for the diagnosis of palpable breast lumps with fine needle aspiration cytology being reserved for definitely benign lesions.

Unusual Breast Neoplasm with Diagnostic and Management Challenges

“…Breast lesions are the leading cause of morbidity and mortality among women worldwide with few cases being reported in males [5,6]. Due to lack of breast screening practice in developing nations, patients present with palpable lumps.…”

“…Due to lack of breast screening practice in developing nations, patients present with palpable lumps. However, there are more benign breast lesions than the malignant breast lesions [3,4,6]. In the malignant category, there are more than dozen variants which are less common but still very well defined by the World Health Organization (WHO) classification [7].…”

Clinical Evaluation of Breast Mass - Fine Needle Aspiration Cytology versus Histopathology - A Comparison Study

“…It is also possible that the smears may be a cellular (no cells are harvested) making cytological analysis impossible. These are described as inadequate aspirates and rates vary markedly, being particularly operator dependent and cases have to be converted to CNB which is able to solve the problem (Tikku and Umap, 2016;Ibikunle et al, 2017;Aly et al, 2014;Kumar and Kothari, 2014;Ige et al, 2014) …”

“…A triple test consisting of clinical examination, mammography and FNAC is considered the gold standard in making a definitive assessment of breast lumps. FNAC is a method that emerged in the 1930s, described by Martin and Ellis (Tikku and Umap, 2016;Sujith et al, 2015), which is used to obtain a sample for cytological analysis of various lesions, including those located in the breast. Currently, it is considered a safe and economical procedure that can avoid unnecessary surgeries by differentiating benign and malignant lesions with great certainty.…”

“…A lump can be discovered by a woman doing a breast self-exam, or by her doctor during a physical examination. Suspicious lumps can also be detected during annual mammograms for early detection (Tikku and Umap, 2016;Kumar et al, 1999;Haas et al, 2005). There is increasing awareness with associated anxiety and stress among women, who perceive every symptom in breast as cancer, compelling them to seek medical advice.…”