Core needle biopsy verses fine needle aspiration cytology in palpable breast lesions- a comparative study

2021 
Background: Cytological diagnosis has its own limitations specially in suspicious lesions and poorly circumscribed lesions in Breast. Core needle biopsy (CNB) emerged as an important tool in assessment of breast lesion with high sensitivity and specificity. The present study was conducted to evaluate the utility, advantages and limitations of FNAC and CNB in palpable breast lumps in the region of Punjab. Methods: The study was conducted on 93 patients attending the cytology section of Pathology Department at SGRDIMSAR, Amritsar. All the patients were subjected to Fine needle aspiration (FNAC) and CNB simultaneously. Both the FNAC smears and sections from CNB were subjected to microscopic examination and were reported according to standard National Health Service Breast Screening Programme criteria. Results: CNB detected 4.4% more cases of malignancy. The suspicious rates on FNA (C3 & C4) with total percentage of 17.2% were 4.1% on CNB (B3 & B4). For diagnosing the malignant lesions concordance rate between FNAC and CNB was 92.3% and for benign lesions it was 80.5%. The sensitivity and specificity of FNAC was 92.15% and 96.5% respectively. Positive predictive value was 97.9% while negative predictive value was 87.5% for FNAC. Conclusion: In the present study we concluded that CNB detects more malignant cases and assign the category of benign and malignant to suspicious/borderline lesions detected on FNAC more definitively. Therefore providing better alternative to open biopsy in such cases for diagnostic purpose. But seeing the advantages of FNAC technique, FNAC is preferred technique in definitely benign lesions. Keywords: CNB, FNAC, Palpable Breast Lesion
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