A PROSPECTIVE AND COMPARATIVE STUDY OF DIAGNOSTIC ACCURACY OF RADIOLOGICAL AND CYTOLOGICAL STUDY FOR BREAST CARCINOMA IN TERTIARY CARE CENTRE

Suman De, Asis Kumar Saha*, Sajib Chatterjee and Nirjhar Bhattacharya

ABSTRACT

Background: Breast cancer is most common cancer in women worldwide, contributing 25.4% of diagnosed cancer in 2018(1). Radiological and cytological pathways are the two main pathways for investigating breast lump. Radiological investigations include mammography and ultrasonography whereas cytological investigation includes FNAC and core needle biopsy (CNB). The diagnostic accuracy of the above mentioned investigations are not cent percent and have their own merits and demerits. Main aim of our study was to determine and compare the diagnostic accuracy of Mammography, USG of breasts and axillae, FNAC and Core Needle Biopsy in patients presenting with breast lumps with the final histology of excised specimen. Methods: 120 patients with breast lump in our tertiary care centre after meeting the inclusion and exclusion criteria were included in the study. All the patients after through clinical assessment had undergone through USG of breast, mammography, FNAC and core needle biopsy. Findings of above all investigations were compared with final histological findings to assess the sensitivity, specificity and diagnostic accuracy. Results: Sensitivity, specificity, PPV, NPV and diagnostic accuracy are 76.92%, 50.0%, 90.91%, 25.0% and 73.33% for USG of breast whereas mammography revealed 88.46%, 75%, 95.83%, 50% and 86.67%. In respect to FNAC as investigating tool we found sensitivity, specificity, PPV, NPV and diagnostic accuracy are 76.92%, 75.0%, 95.24%, 33.33% and 76.67% whereas core needle biopsy revealed 96.15%, 100%, 100%, 80% and 96.67%. Conclusion: Both radiological and cytological investigation can be well utilized in Triple Assessment method for diagnosis of breast lump with high sensitivity rate.

Keywords: Breast lump, FNAC, Mammography, Core needle biopsy