Comparative evaluation of FNAC, core needle biopsy and excisional biopsy in subtyping of breast lesions
Abstract
Background: Although available literature on Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in breast lesions are enormous but studies regarding the comparison of CNB and FNAC in palpable breast lumps within the same patients are very few in eastern part of Uttar Pradesh (Gorakhpur region).Therefore, the present study has been undertaken to evaluate the diagnostic utility of CNB over FNAC and to compare the two with their histopathological examination as an gold standard.
Material and Methods: 68 patients with palpable breast lumps were subjected to FNAC and CNB simultaneously and their findings are correlated with their histopathology. Smears were stained by H&E, MGG and Papanicolau stains and reported using Standard National Health Service Breast Screening Programmes (NHSPSB) guidelines.
Results: On comparing various parameters for FNAC and CNB shows absolute sensitivity (84.6% vs89.7%), specificity (72.4% vs 96.5%), PPV for C4/B4 (66.6% vs 100%), PPV for C3/B3(14.28% vs 0%), FNR (2.56%VS 0%), inadequate FNAC/B1 for cancer(00% vs 2.5%),suspicious rate(19.1% vs 4.4%) and diagnostic accuracy (79.4% vs 92.6%).On analyzing Z values of all parameters it was found to be statistically significant in specificity (Z=2.56;p<0.01), suspicious rate (Z=27;p<0.01) and diagnostic accuracy (Z=2.45;p<0.01).
Conclusion: CNB was more specific than FNAC in correctly typing breast lesions and avoids unnecessary surgical management. It can be used as an alternative to open biopsy for specific diagnosis.
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References
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