Cytomorphologic Study of Breast Lesions: Spectrum of Lesions and Histopathological Correlation

Breast masses are a diagnostic dilemma in clinical practice, even if majority of them are benign. Hence, a reliable and rapid diagnosticmodality is crucial in the management of breast lesions, and fine-needle aspiration cytology (FNAC) has been considered areliable, rapid and economical method when combined with clinical and radiological findings, the triple test, to accurately diagnosepalpable breast masses. It has an estimated sensitivity of 90-99% and a diagnostic accuracy of 96.2%.ObjectivesTo describe cytomorphologic patterns of breast lesions and to determine diagnostic accuracy of FNAC.MethodsA 3 year retrospective cross-sectional descriptive study was conducted. All patients who had breast FNAC from September 2019to August 2022 at pathology department of Jimma University Medical Centre (JUMC) and that fulfilled the eligibility criteria wereselected along with their matching histopathology reports. The collected data was coded, cleaned, and entered into Epidata 3.1,then exported to SPSS v26 and analyzed. Descriptive analysis was done for frequency and distribution of the disease. The riskof malignancy (ROM) for each International Academy of Cytology (IAC) yokahama category was determined and diagnosticperformance was evaluated based on a three-category approach.ResultsAn increasing occurrence of malignant breast lesions was observed, from 21.7% in 2019/20 to 29.9% in 2021/22. The mean agewas 41.4±13.38 and 28.7±11.3 for malignant and benign breast lesions respectively. The most common benign breast lesion wasfibroadenoma 322 (38%) in females and gynecomastia 75 (87.2%) in males. The ROM for each category was for C1 66.6 %, C20%, C3 30.5%, C4 54.5% and C5 98.7 %. The absolute sensitivity, complete sensitivity, specificity, PPV and NPV were 77.2%,100%, 99.1%, 98.7% and 100%, respectively.ConclusionThere is an increasing incidence of malignant breast lesions with majority of the cases occurring in younger patients. The highersensitivity and specificity FNAC in diagnosing malignant lesions supports its use.