Fine-needle aspiration of palpable breast lesions with histopathologic correlation

Abstract

Abstract: Fine-needle aspiration biopsy of the breast has been used as a diagnostic step in the investigation of palpable breast lumps in the Department of Pathology, Tikur Anbessa Hospital, for more than 10 years. The purpose of this study is to evaluate the accuracy of fine-needle aspiration with histopathologic confirmation. A retrospective study was performed using records of fineneedle aspiration and biopsy results and request forms over four and half years. All women and men who had had fine-needle aspiration breast biopsy with histopathologic confirmation of the diagnosis were included. Fine-needle aspirations were interpreted as malignant, suspicious, or benign. Histopathologic diagnosis included incisional, excisional, and mastectomy specimen. A total of 244 patients fulfilled the criteria. Only eight (3.3%) of the specimens were inadequate for study. There were 52 total malignant fine-needle aspiration diagnoses, with only two falsepositive specimens. One was flbroadenoma and the other benign phylloides. There were 20 suspicious readings; 14 of these were malignant and six were false-suspicious specimens. Fibroadenoma, fibrocystic change, and papilloma were two each for the the six false suspicious specimens. Of the 164 lesions interpreted as benign, there were 10 false negative specimens. The test had 86% sensitivity, 95% specificity, 89% positive predictive value, and 94% negative predicitive value. Fine-needle aspiration is a sensitive and highly specific test that can be useful as an adjunct in the diagnosis of breast cancer. “Malignant†and “benign†interpretations are highly predictive but must be used only in the context of other diagnostic modalities. “Suspicious†“atypical†or “papillary†lesions require further investigation. [Ethiop. J. Health Dev. 1999;13(3):181-186]