Relationship of clinical findings of breast lumps with fine needle aspiration cytology and histopathological reports in a tertiary health care facility in Bangladesh

Abstract

Background: Breast lump is a source of great anxiety when it is discovered. Various lesions ranging from inflammation to carcinoma can affect the breast. Carcinoma of the breast is the second most common malignancy among females. So, prompt diagnosis is needed to rule out malignancy. This study aimed to assess the relationship of clinical findings of breast lumps with fine needle aspiration cytology (FNAC) and histopathological reports in a tertiary health care facility in Bangladesh. Methods: This descriptive cross-sectional observational study was conducted in the Surgery Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh, from May 2013 to April 2014. A total of 90 patients presenting with breast lumps were purposively enrolled in the study. Collected data were analyzed using MS Office tools. Results: Among 90 patients, malignancy was diagnosed in 32.22% clinically, 36.67% on FNAC, and 37.78% on histological diagnosis, while benign lesions were identified in 67.78%, 63.33%, and 62.22%, respectively. The most common benign lesion was fibroadenoma (57.15%), followed by fibrocystic disease (19.65%), and the predominant malignant lesion was infiltrating ductal carcinoma (28.89%). Clinical findings showed a diagnostic sensitivity of 82%, specificity of 98.21%, positive predictive value of 96.55%, and negative predictive value of 90.16%. FNAC demonstrated higher sensitivity (94.11%), specificity (98.21%), positive predictive value (96.96%), negative predictive value (96.49%), and overall accuracy (96.66%). Conclusion: Fine needle aspiration cytology (FNAC) of breast lesions demonstrates high sensitivity, specificity, and accuracy as an initial diagnostic tool for palpable breast lesions in our tertiary care hospital. Therefore, FNAC should be routinely recommended as a primary investigation for evaluating breast lumps.