Cytomorphological Patterns and Histopathological Correlation of Breast Lesions in a Tertiary Care Centre- A Two Year Retrospective Study

TLDR: The study shows that out of 1084 patients, only 100 patients who were diagnosed with malignancy on FNAC were reviewed with biopsies or postoperatively in the authors' department and were confirmed histopathologically.

Abstract: Background: Breast lesions including breast cancer represent a major public health issue worldwide. Fine needle aspiration cytology (FNAC) is established as most sensitive, specific, accurate, safe and cost effective for diagnosing lesions of breast preoperatively and avoiding unnecessary surgical interventions like diagnostic excision or incisional biopsy. The aim of this study is to determine the most common breast lesions diagnosed by FNAC and its histopathological correlation over a two year period. Material and Methods: A total of 1084 cases with palpable breast lesions were subjected to FNAC over a period of two year. A provisional clinical diagnosis was made in each case at the outset. Routine investigations like DLC, TLC, ESR and special investigations like Mammography were done. Air dried and wet fixed (95% alcohol) smears were prepared for Leishman and Papanicolaou or Hematoxylin and Eosin stain respectively. Special stains were used like Ziehl- Neelsen stain and Periodic Acid Schiff (PAS) stain wherever necessary. Diagnosis was made on the basis of cytomorphological features of the lesion. Out of 1084 patients, only 100 patients who were diagnosed with malignancy on FNAC were reviewed with biopsies or postoperatively in our department and were confirmed histopathologically. Results: The study shows that out of 1084 cases, total number of benign lesions were 73.8%, malignant lesions were 22.1%, equivocal cases were 7.5%, cases for suspicious of malignancy were 2.9% and 1.75% cases were inadequate. Maximum number of cases reported as breast carcinoma were seen in age group of 41-50 years (31.3%) and second highest number were seen in 51-60 years (26.3%) with male (88 cases) to female (977 cases) ratio of 0.09:1. Among 800 benign lesions, fibroadenoma was the most significant lesion observed constituting 44.9%, second most common lesion encountered was benign mammary lesion constituting 18.9% followed by inflamed/ acute cystic lesion, (47.5%). Gynaecomastia constituting (35.4%),