Comparision of Fine Needle Aspiration Cytology and Fine Needle Sampling without Aspiration in Diagnosis of Palpable Breast Lumps in Mulago Hospital

Abstract

Background: Open biopsy of the breast used to be the main traditional method of diagnosis of breast lumps. Fine Needle Aspiration Cytology (FNAC) was later introduced which depends on suction and thus yields hemorrhagic material for cytological study.This study was undertaken to find out if there is a difference in diagnostic accuracy in using Fine Needle Aspiration Cytology and Fine Needle Sample (FNS) without aspiration in the diagnosis of palpable breast lumps.
Methods: This was a cross-sectional study of women with palpable breast masses of 2cm and above in the widest diameter by ultrasound. Patients were subjected to FNS, FNAC and excision biopsy of the lump or mastectomy where appropriate. Cytodiagnosis of all the cases was compared to the histodiagnoses of the biopsies to establish the sensitivity, specificity and diagnostic accuracy.
Results: Some 85 patients had FNS, FNAC and excision biopsy/mastectomy done. The findings demonstrated that both FNS and FNAC have the same sensitivity of 83.3%, specificity of 100% and diagnostic accuracy of 98.7% in the diagnosis of palpable breast lumps. FNS had good quality smears in 88.2% of the patients as compared to FNAC smears which was 58.8%of the patients.FNS smears were adequate in 95.3% of the patients as compared to FNAC smears which was adequate in 90.6% of the patients.
Conclusion: There was no difference in the diagnostic accuracy of FNS and FNAC in the diagnosis of palpable breast lumps. These findings may suggest that it is probably the adequacy of the cells harvested rather than the quality of the cells harvested which determines the difference in the diagnostic accuracy of the two techniques.