COMPARATIVE ANALYSIS OF THE DIAGNOSTIC ACCURACY OF FINE-NEEDLE ASPIRATION CYTOLOGY (FNAC) VERSUS TRUE-CUT BIOPSY IN THE DETECTION OF MALIGNANCY WITHIN DETECTABLE BREAST MASSES.
Main Article Content
Keywords
FNAC, Diagnosis, diagnostic accuracy, malignancy, breast lump, Tru-Cut biopsy
Abstract
Background: Breast cancer remains the prevailing malignancy affecting women universally and is a leading contributor to cancer-related fatalities among the female population, with a significant burden in developing nations.
Objective: This research aimed to evaluate the diagnostic precision of needle aspiration Cytology (FNAC) in the identification of malignancy within palpable breast lumps. A parallel objective was to conduct a comparative analysis with a Tru-Cut biopsy.
Study design: An analytical cross-sectional study
Place and Duration: This study was conducted in Peoples University of medical and Health sciences for women Nawabshah from May 2022 to May 2023
Methodology: The inclusion criteria encompassed patients visiting the hospital's breast clinic who presented with detectable breast lumps. Histopathological evaluations were performed on specimens procured via FNAC, Tru-Cut biopsy, and excisional biopsy. Subsequent application of Hematoxylin and Eosin (H&E) staining facilitated the histological examination of both the Tru-Cut biopsy and tissue samples from the excision procedures.
Results: Out of the 110 cases under investigation, malignancy was identified in 31.82% (n=35). The diagnostic precision of Tru-Cut biopsy in detecting cancer within patients displaying palpable breast lumps, with histopathology examination after excision biopsy (HPE) as the gold standard It demonstrated a sensitivity of 82.86%, a specificity of 95.24%, a positive predictive value (PPV) of 88.57%, a negative predictive value (NPV) of 92.31%, and an accuracy rate of 89.09%. The calculated likelihood ratio was 19.75. Conversely, FNAC biopsy's diagnostic accuracy in detecting malignancy within palpable breast lumps, utilizing HPE as the reference standard, yielded a sensitivity of 71.43%, a specificity of 92.68%, a PPV of 80.95%, NPV of 85.71%, and an accuracy rate of 81.82%. The calculated likelihood ratio was 10.21.
Conclusion: Regarding the diagnosis of cancer within patients presenting palpable lumps in the breast, both FNAC and Tru-Cut biopsy demonstrate commendable diagnostic accuracy. However, Tru-Cut biopsy exhibits heightened accuracy in comparison to FNAC for detecting this pathological condition.
References
2. Woodhams R, Matsunaga K, Kan S, Hata H, Ozaki M, Iwabuchi K, Kuranami M, Watanabe M, Hayakawa K. ADC mapping of benign and malignant breast tumors. Magnetic resonance in medical sciences. 2005;4(1):35-42.
3. Zardavas D, Irrthum A, Swanton C, Piccart M. Clinical management of breast cancer heterogeneity. Nature reviews Clinical oncology. 2015 Jul;12(7):381-94.
4. Bdour M, Hourani S, Mefleh W, Shabatat A, Karadsheh S, Nawaiseh OS, Ebous A. Comparison between fine needle aspiration cytology and tru-cut biopsy in the diagnosis of breast cancer. J Surg Pak (Int). 2008 Jan;13(1):19-21.
5. Krishna CM, Narendra MC, Mutheeswaraiah Y, Prakash GV, Nagamuneiah S, Rao BS, Sravya S. Evaluation of Role of Tru-Cut Biopsy in the Diagnosis of Clinically Palpable Breast Lumps. Journal of Evolution of Medical and Dental Sciences. 2020 Apr 13;9(15):1281-6.
6. Samantaray S, Panda N, Besra K, Pattanayak L, Samantara S, Dash S. Utility of tru-cut biopsy of breast lesions-an experience in a regional cancer center of a developing country. Journal of Clinical and Diagnostic Research: JCDR. 2017 Mar;11(3):EC36.
7. Ahmed I, Nazir R, Chaudhary MY, Kundi S. Triple assessment of breast lump. Journal of the College of Physicians and Surgeons--pakistan: JCPSP. 2007 Sep 1;17(9):535-8.
8. Rikabi A, Hussain S. Diagnostic usefulness of tru-cut biopsy in the diagnosis of breast lesions. Oman medical journal. 2013 Mar;28(2):125.
9. Dimitrov DD, Karamanliev MP, Deliyski TS, Gabarski AV, Vatov PP, Gencheva RO, Ivanov CM, Popovska SL, Valcheva GB, Nanev VD, Ivanov TM. Diagnostic value of tru-cut biopsy in diagnosing breast lesions. Journal of Biomedical and Clinical Research. 2016;9(2):126-9.
10. Laishram S. Diagnostic Accuracy of Fine Needle Aspiration Cytology, Triple test and Tru-cut Biopsy in the Detection of Breast Lesion. The Journal of Medical Research. 2016;2(6):133-4.
11. Afridi SP, Ahmed S. Profile of breast cancer patients. Journal of Surgery Pakistan (International). 2012 Jul;17:3.
12. Ajitha M, Babu V, Singh A. Comparative study of fine needle aspiration cytology, trucut biopsy and final histopathological examination in breast lumps. Int J Biomed Res. 2017;8(3):34-5.
13. Jan Y, Hussain S, Waqas SM, Din A, Khan A. Comparison of fine needle aspiration cytology (FNAC) and Trucut biopsy in evaluation of suspicious palpable breast lesions. Rawal Med J. 2016 Apr 1;41:205-8.
14. Wang M, He X, Chang Y, Sun G, Thabane L. A sensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in evaluation of suspicious breast lesions: A systematic review and meta-analysis. The breast. 2017 Feb 1;31:157-66.
15. Shashirekha CA, Singh R, Ravikiran HR, Sreeramulu PN, Prasad K. Fine needle aspiration cytology versus trucut biopsy in the diagnosis of breast cancer: a comparative study. International Surgery Journal. 2017 Oct 27;4(11):3718-21.
16. Zanconati F, Romano A, Martellani F, Ober E, Giudici F, Pinamonti M, Bonifacio D, Bottin C, Tonutti M, Bortul M, Zacchi A. Breast FNAC in Mammografic Screening Program of Trieste, Italy. Cytopathology. 2012;23(1):31-.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Masood Ahmed
Associate Professor General Surgery, Peoples University of medical and Health sciences for women Nawabshah Pakistan
Muhammad Tariq Ayub
Resident General Surgery, Zayed Military Hospital Abu Dhabi UAE.
Rehana Raza
Specialist General Surgery, Zubeda khaliq Memorial Free Hospital Skardu Pakistan.
Muhammad Bilal Ghazipura
Consultant General and Laparoscopic Surgeon, Ain Al Khaleej Hospital Alain Abudhabi UAE.
Abdul Rehman
Assistant Professor of Anatomy, Bhitai Dental and Medical College Mirpurkhas Pakistan.
Lailama Shah Sherani
Assistant Professor General Surgery, Federal General Hospital Islamabad Pakistan.