Mallegowdanadoddi Siddegowda1, Tahniyat Ara2
BACKGROUND
Breast lump is fairly a common complaint in females for which patient seeks
medical advice and becomes anxious about the diagnosis. Quick diagnosis by fineneedle
aspiration cytology (FNAC) relieves patient’s anxiety and assists in their
preoperative management and overall treatment. This study was conducted to find
out the cytomorphological patterns and distribution of breast lesions in various
age groups in our institute.
METHODS
This is a prospective observational study of breast lesions conducted in the Mandya
Institute of Medical Sciences, Mandya, for a period of 18 months from January
2016 to June 2017. About 200 cases were studied by cytology and correlated with
histopathology wherever biopsy specimens were available, and were stained with
haematoxylin and eosin (H & E) and May–Grunwald–Giemsa stains (MGG). Cases
were grouped according to the five-tier reporting format for breast lesion (C1 –
C5) laid down by National Cancer Institute.
RESULTS
The spectrum of breast lesions on cytomorphological interpretation was 1 %
inadequate / insufficient material (C1), 80 % benign (C2), 1.5 % atypia probably
benign (C3), 0.5 % suspicious of malignancy (C4) and 17 % malignant (C5). Out
of 200 cases studied, 160 cases were benign lesions, and 34 cases were malignant
lesions. Most of the benign lesions belonged to the age group 21 - 30 years
followed by 31 - 40 years. Malignant lesions were maximum in the age group of
41 - 50 years. In benign disease, fibroadenoma was the commonest i.e. (31 %)
followed by fibrocystic change (22 %), benign epithelial hyperplasia (8.7 %), acute
mastitis (3 %), chronic mastitis (2 %), epidermal cyst (1.8 %), subareolar abscess,
granulomatous mastitis, galactocele (1 %) and gynaecomastia (8.5 %). In the
malignant group, infiltrating ductal carcinoma - not otherwise specified, was the
commonest lesion (82.4 %), followed by mucinous carcinoma (8.8 %), papillary
carcinoma, medullary carcinoma and metaplastic carcinoma (2.9 %). In this study,
the specificity, sensitivity, positive and negative predictive value, and diagnostic
accuracy of fine-needle aspiration cytology were 100 %, 90 %, 100 %, 95 %, and
96 %, respectively.
CONCLUSIONS
FNAC of the breast lump is an easily performed outpatient diagnostic method for
determining the nature of the breast mass.
