Role of Fine-Needle Aspiration Cytology in Evaluation of Breast Lumps

  • Ashish Kosthi
  • Maneesh Sulya Assistant Professor,Department of Pathology,Gandhi Medical College , Bhopal, M.P. Pin No.462001
  • Reeni Malik
Keywords: FNAC, breast lesions, fibroadenoma, ductal carcinoma.


Background: Breast lump is most common presentation in most of the breast diseases. Fine-Needle Aspiration Cytology (FNAC) is the immediate tool of the physician when first time patient is examined. The method is rapid, accurate, minimally invasive and serve as a therapeutic procedure when a cyst is encountered.Method: This is a retrospective hospital based study conducted at department of Pathology,Gandhi Medical College, Bhopal over a period of two and a half years. It included 531 patients with breast lump attending the outpatient department (OPD).Result: FNAC was done on 531 cases of breast lump, 31 (5.84%) cases were not satisfactory and remaining 500 (94.16%) were satisfactory enough for a cytological diagnosis. Out of 500 cases, benign lesions were 358 (71.60%), malignant lesions were 87 (17.40%), inflammatory lesions were 41 (8.20%) and suspicious category include 14 (2.80%). Fibroadenoma was the most common benign lesion and ductal carcinoma was the common malignant lesion. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC was 98.13%, 100%, 100%, 98.98% and 99.34% respectively.Conclusion: FNAC of the breast lump is a simple, safe, economical, and rapid diagnostic procedure which can be used routinely on OPD basis, because the cytopathological examination of these lesions before operation or treatment serves as an important diagnostic modality.DOI: 10.21276/AABS.1602

Author Biography

Maneesh Sulya, Assistant Professor,Department of Pathology,Gandhi Medical College , Bhopal, M.P. Pin No.462001
Assistant Professor, Department of Pathology,Gandhi Medical College Bhopal m.p.


1. M. Auger and I. Huttner, “Fine-needle aspiration cytology of pleomorphic lobular carcinoma of the breast: Comparison with the classic type,” Cancer, vol. 81, no. 1, pp. 29–32, 1997.
2. M. H. Bukhari and Z. M. Akhtar, “Comparison of accuracy of diagnostic modalities for evaluation of breast cancer with review of literature,” Diagnostic Cytopathology, vol. 37, no. 6, pp. 416–424, 2009.
3. Susan C. Lister. The Breast. In, Kumar, Abbas, Fausto, Aster(Ed). Robbins and Cotran Pathologic basis of disease.8th edition. Philadelphia, Pensylvania, Saunders,2010;1066-8.
4. M. Rubin, K. Horiuchi, N. Joy et al., “Use of fine needle aspiration for solid breast lesions is accurate and costeffective,” American Journal of Surgery, vol. 174, no. 6, pp. 694– 698, 1997.
5. A. Berner, E. Sigstad, W. Reed, and B. Risberg, “Fine-needle aspiration cytology or core biopsy when diagnosing tumours of the breast,” Tidsskrift for den Norske Laegeforening, vol. 123, no. 12, pp. 1677–1679, 2003.
6. D. Lieu, “Value of cytopathologist-performed ultrasoundguided fine-needle aspiration as a screening test for ultrasound- guided core-needle biopsy in nonpalpable breast masses,” Diagnostic Cytopathology, vol. 37, no. 4, pp. 262–269, 2009.
7. T. Ishikawa, Y. Hamaguchi, M. Tanabe et al., “False-positive and false-negative cases of fine-needle aspiration cytology for palpable breast lesions,” Breast Cancer, vol. 14, no. 4, pp. 388– 392, 2007.
8. Hindle WH, Payne PA, Pan EY. The use of fineneedle aspiration in the evaluation of persistent palpable dominant breast masses. Am J Obstetrics Gynaecol 1993; 168 (6 Part 1): 1814—8.
9. Yong WS, Chia KH, Poh WT, Wong OY. A comparison of trucut biopsy with fine needle aspiration cytology in the diagnosis of breast cancer. Singapore Med J 1999; 40(09): 123-123.
10. Francis IM, Das DK. Role of fine needle aspiration, intraoperative imprint cytology and frozen section in the diagnosis of breast lumps and thyroid lesions. Medical principles and practice 1999; 8: 173-182.
11. Dutta SK, Chattopadhyaya A, Roy S. Fine needle aspiration and imprint cytology in the diagnosis of breast lesions. Journal of the Indian Medical Association. 2001 August; 99(8): 421- 23.
12. H. Zakhour and C. Wells, Diagnostic Cytopathology of the Breast, Churchill Livingstone, London, UK, 1999.
13. C. D. Scopa, D. Koukouras, J. Androulakis, and D. Bonikos, “Sources of diagnostic discrepancies in fine-needle aspiration of the breast,” Diagnostic Cytopathology, vol. 7, no. 5, pp. 546–548, 1991.
14. K. R. Lee, R. S. Foster, and J. L. Papillo, “Fine needle aspiration of the breast. Importance of the aspirator,” Acta Cytologica, vol. 31, no. 3, pp. 281–284, 1987.
15. L. A. Brown and S. B. Coghill, “Fine needle aspiration cytology of the breast: factors affecting sensitivity,” Cytopathology, vol. 2, no. 2, pp. 67–74, 1991.
16.“The uniform approach to breast fine needle aspiration biopsy. A synopsis,” Acta Cytol, vol. 40, pp. 1120–1126, 1996.
17. S. Boerner and N. Sneige, “Specimen adequacy and false-negative diagnosis rate in fine-needle aspirates of palpable breast masses,” Cancer, vol. 84, no. 6, pp. 344–348, 1998.
18. L. J. Layfield, E. E. Mooney, B. Glasgow, S. Hirschowitz, and A. Coogan, “What constitutes an adequate smear in fine-needle aspiration cytology of the breast?” Cancer, vol. 81, no. 1, pp. 16–21, 1997.
19. NHSBSP. Non-operative Diagnosis Subgroup of the National Coordinating Group for Breast Screening Pathology. 2001, Publication No 50.
20. NHSB. Guidelines for cytology procedures and reporting on fine needle aspirates of the breast. Cytology Subgroup of the National Coordinating Committee for Breast Cancer
Screening Pathology. Cytopathology 1994;4:316–34.
21. The uniform approach to breast fine-needle aspiration biopsy. NIH Consensus Development Conference. Am J Surg 1997;174:371–85.
22. Perry N, Broeders M, de Wolf C, To¨ rnberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition–
summary document. Ann Oncol 2008;19:614–22.
23. Ahmed H.G. Ali AS, Almobarak AO. Frequency of breast cancer among Sudanese patients with breast palpable lumps. Indian Journal of Cancer 2010:47(1):23-26.
24. Sandhu DS, Sandhu S, karwasra RK, Marwah S. Profile of breast cancer patients at a tertiary care hospital in north India. Indian Journal of Cancer 2010; 47(1):16-22.
25. J.A. Zuk, G Maudsley, H D Zakhour, Rapid reporting on fine needle aspiration of breast lumps in outpatients. J Clin Pathol 1989; 42:906-11.
26. Kuldeep Singh, Satish Sharma, V.K. Dubey, P.R. Sharma. Role of FNAC in diagnosis of breast lumps. JK Science 2001:3(3):126-28.
27. G Jayaram, SF Alhady, CH Yip, Cytological anaysis of breast lesions: a review of 780 cases. Malaysia J Pathol 1996; 18(2):81-87.
28. Pradhan M. Dhakal HP. Study of breast lump of 2246 cases by fine needle aspiration, J Nepal Med Assoc 2008; 47 (172): 205-9.
29. Hyun Joo Choi, In Ae Park. Fine needle aspiration cytology of metastatic choriocarcinoma presenting as a breast lump- a case report. Act cytol 2004; 48:91-94.
30. A.A. Pandit, K.S. Mayekar. Fine needle aspieration cytology of the breast tumour. Indian Journal of Cancer 1988:25:136-43.
31. A Goel, CM Bhan, K N Srivastava. Five year Clinicopathological study of Breast cancer cancer. Ind J Med Sci 2003; 57(8):347-49.
32. Kusum Verma & Kusum Kapila. The role of fine needle aspiration cytology of breast lumps in the management of patients. Indian J Med. Res. 1989:90:135-39.
33. Qungqing He, Xihong Fan Tinggui Yuan, Lixin Kong, Xiumin Du, Dayong Zhuang, Ziyi Fan. Evelven years of experience reveals that fine needle aspiration cytology is still a useful method for preoperative diagnosis of breast carcinoma. The Breast 2007; 16:303-06.
Original Article