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

Masood Ahmed
Muhammad Tariq Ayub
Rehana Raza
Muhammad Bilal Ghazipura
Abdul Rehman
Lailama Shah Sherani

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.

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