DIAGNOSTIC ACCURACY OF FNAC IN DIAGNOSING CLINICALLY SUSPECTED BREAST LESIONS TAKING HISTOPATHOLOGY AS GOLD STANDARD IN TERTIARY CARE HOSPITAL

Abstract

Background: Palpable breast lumps represent   frequent clinical presentation in surgical outpatient departments  necessitating prompt  reliable preoperative diagnosis. Fine Needle Aspiration Cytology (FNAC) is widely utilized as   rapid  minimally invasive triage tool. This study aimed to determine   diagnostic accuracy of FNAC in diagnosing clinically suspected breast lesions  taking histopathology as   reference gold standard in   tertiary care setting.

Methods:   cross-sectional validation study was conducted at   Department of Pathology  Allama Iqbal Medical College / Jinnah Hospital  Lahore  comprising 166 female patients aged 12 to 65 years presenting  of palpable breast masses. Enrolled participants underwent pre-operative cytological evaluation via FNAC followed by definitive histopathological examination of excision or core needle biopsy specimens. Standard operational criteria categorized lesions into benign or malignant. Diagnostic performance parameters—including sensitivity  specificity  positive predictive value (PPV)  negative predictive value (NPV)  and overall diagnostic accuracy—were computed using   standard  2 x 2  contingency table.

Results:   mean age of   patient cohort was  39.75 SD 12.74  years. Histopathology confirmed malignancy in 33 cases (19.88% disease prevalence) and benign pathology in 133 cases. Cross-tabulation revealed 30 true positives  129 true negatives  4 false positives  and 3 false negatives. FNAC demonstrated   sensitivity of 90.91%  specificity of 96.99%  PPV of 88.24%  NPV of 97.73%  and   overall diagnostic accuracy of 95.78%.

Conclusion: FNAC is   highly accurate  sensitive  and specific diagnostic modality for evaluating palpable breast lesions. Its exceptional negative predictive value allows for confident conservative outpatient management of benign lesions while expediting definitive surgical care for malignancies