Role of fine needle aspiration in diagnosing breast lesions

OBJECTIVE: To determine the diagnostic efficacy of breast fine needle aspiration (FNA), using 72 cases that were having both FNA cytology and follow-up histology diagnosis. The study results were compared with results of 27 other studies in the literature. A review of literature regarding the additional benefits of performing "Triple Test" in increasing the cumulative diagnostic accuracy of FNA is also included.

METHODS: Our study group consisted of 72 FNA cytologies of female breasts performed at our institution and followed by a histological diagnosis. The following parameters: Sensitivity, specificity, accuracy, predictive values, false positive and negative fraction rates were determined to establish the diagnostic efficacy of the breast FNA.

RESULTS: The sensitivity of FNA procedure was 98.4% and specificity 60%, with the predictive value for positive diagnosis 93.9% and for negative diagnosis 85.7%. The overall diagnostic accuracy was 93%. The false positive fraction was 6% and the false negative fraction was 14.2%. The false positive and false negative cases were recorded as having a minimal effect on patient management, as all the false positive and negative diagnosis' were picked up at intra operative frozen sections, and hence no over or under treatment was given to the patients due to these FNA results.

CONCLUSION: Fine needle aspiration breast biopsy is an efficient tool and yields a definitive diagnosis, and its use for routine diagnosis must be encouraged since it has high positive (93.9%) and negative (85.7%) predictive values.