The diagnostic accuracy of fine needle aspiration cytology versus core needle biopsy for palpable breast lump(s).

OBJECTIVES: Breast lump is one of the most common surgical problems in females. Surgical biopsy of palpable breast lump was considered the gold standard for the diagnosis of breast lump(s). Emphasis has been placed on improving method for establishing a definitive diagnosis of breast mass prior to surgery. Our aim was to compare the diagnostic accuracy of fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients with palpable breast masses.

METHODS: Prospective randomized controlled clinical trial included 296 Female patients with breast lumps, presented to Al-Thawra Teaching Hospital, Sanaa, Yemen between May 1998 -- May 2002. All the patients submitted either to FNAC or CNB equally. The results were then compared with the final diagnosis by histopathology.

RESULTS: The patient age ranged from 15-74 years with a mean of 33.77 ± 11.91 years. Married patients were 69.3% and the most common presentation was breast lump(s) (88.5%). The mean size of the tumor was 3.47 ± 1.43 cm in diameter. The FNAC sensitivity was 66.66%, 81.8% specificity, 75.7% accuracy, positive predictive value (PPV) 100% and negative predictive value (NPV) 90%, while in core needle breast biopsy sensitivity was 92.3%, 94.8% specificity, 93.4% accuracy, PPV 100% and NPV 100%. The diagnostic accuracy of CNB was higher than the FNAC, which was statistically significant (p<0.05).

CONCLUSIONS: Both procedures are simple, easy, safe, cheap and reliable, but CNB is more accurate than the FNAC.