Accuracy of Fine Needle Aspiration in 128 Cases Palpable Breast Masses in Medical Centers of Iran University of Medical Sciences during 2005-2008

Introduction & Surgical biopsy of palpable breast lump was considered as the gold standard for the diagnosis of breast lump(s). Emphasis has been placed on improving methods for establishing a definitive diagnosis of breast masses prior to surgery. In developed countries breast fine-needle aspiration (FNA) has been increasingly an accepted as an important triage tool for the evaluation of breast lumps. In this research, our aim was to determine the diagnostic accuracy of fine needle aspiration cytology (FNAC) in patients with palpable breast masses During 2005-2008 we examined the clinical utility and the diagnostic accuracy of breast FNAB result by studying 128 breasts mass. Cases were collected from two large university- affiliated teaching hospitals and clinics. After FNAB, all the patients were subjected to excisional biopsy. The cytologic diagnoses were classified into five groups: C1(Inadequate), C2(Benign), C3 and C4(Intermedite), and C5(malignant). We analyzed the collected data by SPSS 15. This study was performed on 128 patients. It involved 118 females and 10 male. The mean age was 42±14 years old. All patients underwent FNAB performed. Conclusive malignancy (C5) was found in 46(36%) patients and in 9 patients, malignancy was suspected (C4). Conclusive benign lesions (C2) were found in 34% patients and 2 patients had atypia i.e. (C3). Inadequate specimen (C1) was found in 28(22%) patients. On excision biopsy, 46%patients had malignant lumps and 53% were benign. FNAB was able to detect 45 malignant lumps, with sensitivity of 91%. Most of them were also reported malignant on excision biopsy, with specificity of 97%. False positive was 3% and false negative was 9%. PPV was 97% and NPV was 91%. Overall FNA accuracy was 94%. Fine needle aspiration biopsy of solid palpable breast lesions should be the diagnostic procedure of choice for those patients who are clinically classified as probably benign or clinically as highly suspicious for cancer. It can be the diagnostic modality choice in adolescent and young female. For highly suspicious cases, a negative fine needle aspiration should not deter an open surgical biopsy. For patients classified as Intermediate, fine needle aspiration biopsy results are not reliable enough to determine treatment. FNA is a reliable substitute for exicional biopsy for obtaining a definitive preoperative diagnosis.