DIAGNOSTIC ACCURACY OF FNAC AND CORE NEEDLE BIOPSY IN PALPABLE BREAST LUMPS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF COMPARATIVE STUDIES
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Keywords
Fine Needle Aspiration Cytology (FNAC), Core Needle Biopsy (CNB), Diagnostic Accuracy, Sensitivity, Specificity, Breast Lump, Systematic Review and Meta-Analysis.
Abstract
BACKGROUND: Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy (CNB) are most widely used diagnostic procedures for the evaluation of palpable breast lumps. Despite being less invasive than CNB, FNAC´s diagnostic reliability remains inconsistent. By identification of relevant studies from current scientific literature, this systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of FNAC and CNB in suspicious breast lumps.
METHOD: Various comparative studies on FNAC and CNB in diagnosing palpable breast lumps were included in this systematic review and meta-analysis. Studies reporting on sensitivity, specificity, and diagnostic accuracy were included by carrying out a comprehensive literature search over databases of last 6 years. Forest plots were drawn to display the sensitivity and specificity of FNAC and CNB respectively.
RESULTS: The pooled sensitivity of FNAC ranged from 35% to 96.61%, while CNB consistently exhibited high sensitivity range of 82.86% to 100%. Similarly, FNAC specificity ranged from 48% to 100%, whereas CNB specificity was more consistent 86% to 100%, thus endorsing better histological differentiation between benign and malignant pathologies. The diagnostic accuracy of FNAC ranged from 71.4% to 96.6%, while CNB demonstrated higher and more consistent accuracy of 82.8% to 100%. False negatives were higher in the FNAC group, particularly in inflammatory breast pathologies, whereas CNB had minimal false negatives, ensuring greater diagnostic accuracy.
CONCLUSION: This meta-analysis and systematic review concluded that CNB had got higher diagnostic accuracy, sensitivity, and specificity compared to FNAC in evaluation of palpable breast lumps.
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Muhammad Aslam Javed
Associate Professor of Surgery, Sharif Medical and Dental College Lahore.
Huma Aslam
Associate Professor of Pathology, Sahiwal Medical College, Sahiwal.
Muhammad Hassan
Assistant Professor of Surgery, Sharif Medical and Dental College Lahore.
Mudassar Murtaza
Associate Professor of Surgery, Central Park Medical College, Lahore.
Muhammad Arshad
Senior Registrar of Surgery, Sir Ganga Ram Hospital/FJMU Lahore.
Muhammad Mohsin Gillani
Professor of Surgery, Sharif Medical and Dental College Lahore.