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Year : 2020  |  Volume : 7  |  Issue : 1  |  Page : 5-9

Diagnostic pitfalls in the fine needle aspiration cytology of the breast

1 Department of Pathology, Yenepoya Medical College, Mangaluru, Karnataka, India
2 DDRCSRL Diagnostics Services, Kozhikode, Kerala, India

Correspondence Address:
Dr. Prema Saldanha
“Flushing Meadows,” Pandeshwar, Mangalore 575001, Karnataka.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mgmj.MGMJ_40_20

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Background: Fine needle aspiration cytology (FNAC) of the breast is a reliable, simple, minimally invasive, cost-effective procedure with high sensitivity, specificity, and diagnostic accuracy. It is commonly used for the assessment of breast lesions and as a guide to preoperative evaluation and management. Objective: The objective of this study was to assess the accuracy of fine needle aspiration of the breast and critically evaluate the cases, which showed discordance between cytology and histopathology. Materials and Methods: This is a retrospective study of cases of FNAC done for breast lumps. The slides were retrieved from the archives of the Pathology Department. Breast cytology findings were reported according to the six standard categories—positive for malignancy, suspicious for malignancy, atypical, proliferative without atypia, benign/unremarkable, and unsatisfactory. The FNAC findings were correlated with the histopathology diagnosis. Cases showing cytological and histological disparity were reevaluated for the detection of possible causes of the discrepancy. Results: The study consisted of 100 cases. For the diagnosis of carcinoma, the sensitivity was found to be 92.9%, specificity was 100%, positive predictive value was 100%, negative predictive value was 97.2%, and the total accuracy was 99%. False positives were not seen, and two cases were false negatives. Suboptimal material, lack of extensive sampling, and absence of all the characteristic features caused under diagnoses were recognized as common pitfalls. Conclusion: This study highlights the causes of cytological pitfalls. Strict adherence to the proposed criteria and extensive sampling of the lesions are of paramount importance in reducing the number of false-positive and false-negative cases.

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