Evaluation of Fine needle aspiration cytology in the diagnosis of suspicious/gray zone lesions in breast lesions and its histopathological correlation

Introduction: Fine needle aspiration cytology (FNAC) is an established tool in the diagnosis of palpable lesions. FNAC is a sensitive and rapid method in differentiating benign breast lesions from malignant ones. But there exist some gray areas in which this differentiation becomes difficult. Problem arises in categories C3 and C4 in which there exists significant interobserver variation in the diagnosis. The study was done to evaluate the usefulness of FNAC in diagnosis of C3 and C4 categories and correlate it with histopathological diagnosis. Methods: This Study was conducted on 512 cases of breast FNAC in from January 2014 to December 2014. FNAC diagnosis of C3 and C4 categories were selected. The cytological diagnosis was compared with histopathological diagnosis in the cases where biopsy was done subsequent to FNAC diagnosis. Results: C3 and C4 categories constituted 28 (5.46%) and 48 (9.3%) cases respectively. Histopathology was available in 13 cases of C3 (46.4%) and 30 cases of C4 (62.5%). Among C3 category, 10/13 cases showed benign lesions (77%) and 3/13 cases were malignant (23%). Among C4 category, 4/30 cases showed benign lesion (13.3%) and 26/30 cases were malignant (86.7%). There was a significant statistical difference between benign and malignant diagnosis of C3 & C4 categories (p< 0.001). Conclusion : Clinicians and pathologists should understand the limitations of FNAC. C3 and C4 categories should still be continued with, as there was a statistically significant difference in benign & malignant diagnosis for these categories in our study.

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