Comparison of ultrasonography and fine needle aspiration cytology in the diagnosis of malignant breast lesions.

INTRODUCTION: Breast cancer is the most common cancer of women worldwide and usually presents as lump in the breast. Ultrasonography and Fine Needle Aspiration Cytology (FNAC) are two investigational tools often used to differentiate malignant breast lump from benign one. Aims and Objects: To find out and compare the sensitivity, specificity and predictive values of ultrasonography and FNAC in diagnosing malignant breast lump.
MATERIAL AND METHODS: Patients who presented with clinically palpable breast lump at the department of Surgery, RIMS, India, from September, 2010 to August, 2012, were included. Recurrent lumps, breast abscess and cystic breast lumps were excluded. All the patients underwent Ultrasonographic evaluation using 7.5 MHz probe (©SIEMENS, Sonoline Versa Plus) at the department of Radiodiagnosis, RIMS and FNAC at the department of Pathology, RIMS. All the patients underwent excision of the lumps and tissues were sent for Histopathological examination. Sensitivity, specificity and predictive values of ultrasonography and FNAC were calculated taking Histopathological result as the gold standard. Values were compared.
RESULTS: Sixty patients with 62 breast lumps (40 benign and 22 malignant) were included. FNAC reported 42 lumps as benign and 19 as malignant and was indeterminate in 1 case. Ultrasonography reported 36 cases as benign, 18 as malignant and 6 as indeterminate; it failed to detect breast lump in 2 cases. Sensitivity, specificity, positive and negative predictive values of ultrasonography and FNAC in diagnosing malignant breast lump were respectively 94.74%, 100%, 100%, 97.22% and 90.48%, 100%, 100%, 95.24%.
CONCLUSION: Ultrasonography and FNAC are 100% specific in diagnosing malignant breast lesion. Although Ultrasonography appears more sensitive than FNAC, the percentage of indeterminate report is higher with Ultrasonography.