Fine needle aspiration biopsy of breast lesions and histopathologic correlation - An analysis of 837 cases in four years

OBJECTIVE: To correlate fine needle aspiration biopsy (FNAB) and histopathology in 837 cases. STUDY DESIGN: A study consisting of 837 FNABs of breast lesions and their histopathologic correlation was conducted at Goa Medical College Hospital, Bambolin, Goa, India, over a period of four years, from January 1987 to December 1990. Six hundred cases were followed with excision biopsy/mastectomy, and a cytohistologic correlation was established. The diagnostic accuracy of this series was assessed and compared with data obtained from the Indian and international literature. RESULTS: The diagnostic accuracy of this series (sensitivity 93.80%, specificity 98.21%, predictive value of a positive result 92.70%, efficiency 97.40%) was compared with that in published reports. Statistically significant differences were found between the levels of diagnostic accuracy in series published by pathologists who diagnosed smears prepared by clinicians and surgeons (group A) and series published by pathologists who performed palpation and aspiration and made the cytologic diagnosis themselves (group B). These differences consisted mainly of a lower number of false positives and unsatisfactory samples in group B. CONCLUSION: Fine needle aspiration biopsy is an effective modality for the diagnosis of breast lesions. Lower rates of false positive and false negative diagnosis are achieved if the cytopathologist has personally performed the FNAB, prepared the smears and performed the microscopic interpretation. The diagnostic accuracy achieved with direct smear preparation is as good as that obtained by the newer Cytospin method for FNAB.