Contribution of Fine-Needle Aspiration Cytology and Ultrasonography Versus Histopathology in Diagnosing Breast Lumps

Abstract

Breast carcinoma remains a significant global health concern for women. Accurate diagnosis of breast cancer relies on a thorough clinical history and examination, along with the rational use of imaging techniques and tissue diagnosis. The study analyzed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of fine-needle aspiration cytology (FNAC) and ultrasonography (USG) compared to histopathology at Tobruk Medical Center (TMC), Tobruk, Libya. Records of all patients who presented to the general surgery department with a clinically suspicious breast lump or mass between 2014 and 2017 were reviewed. FNAC and histopathology reports were retrieved from the Department of Pathology at TMC. The study retrospectively reviewed FNAC and USG reports for 42 patients, and the results were compared with histopathological diagnoses. The sensitivity, specificity, PPV, and NPV of FNAC for diagnosing malignant breast lesions were 86%, 80%, 96.9%, and 44.4%, respectively. For USG, the sensitivity and PPV were 87.9% and 96.7%, respectively. Specificity and NPV for USG could not be determined due to the lack of true-negative cases. Indeterminate results were more frequent with USG than with FNAC (19% vs. 2.38%, respectively). In summary, FNAC and USG are best used in combination, as both techniques showed high PPV in the diagnosis of breast malignancy.