A Study of Patterns of Breast Lesions Diagnosed on Fine-Needle Aspiration Cytology in a Tertiary Care Hospital of Mandya

BACKGROUND Breast lump is fairly a common complaint in females for which patient seeks medical advice and becomes anxious about the diagnosis. Quick diagnosis by fineneedle aspiration cytology (FNAC) relieves patient’s anxiety and assists in their preoperative management and overall treatment. This study was conducted to find out the cytomorphological patterns and distribution of breast lesions in various age groups in our institute. METHODS This is a prospective observational study of breast lesions conducted in the Mandya Institute of Medical Sciences, Mandya, for a period of 18 months from January 2016 to June 2017. About 200 cases were studied by cytology and correlated with histopathology wherever biopsy specimens were available, and were stained with haematoxylin and eosin (H & E) and May–Grunwald–Giemsa stains (MGG). Cases were grouped according to the five-tier reporting format for breast lesion (C1 – C5) laid down by National Cancer Institute. RESULTS The spectrum of breast lesions on cytomorphological interpretation was 1 % inadequate / insufficient material (C1), 80 % benign (C2), 1.5 % atypia probably benign (C3), 0.5 % suspicious of malignancy (C4) and 17 % malignant (C5). Out of 200 cases studied, 160 cases were benign lesions, and 34 cases were malignant lesions. Most of the benign lesions belonged to the age group 21 - 30 years followed by 31 - 40 years. Malignant lesions were maximum in the age group of 41 - 50 years. In benign disease, fibroadenoma was the commonest i.e. (31 %) followed by fibrocystic change (22 %), benign epithelial hyperplasia (8.7 %), acute mastitis (3 %), chronic mastitis (2 %), epidermal cyst (1.8 %), subareolar abscess, granulomatous mastitis, galactocele (1 %) and gynaecomastia (8.5 %). In the malignant group, infiltrating ductal carcinoma - not otherwise specified, was the commonest lesion (82.4 %), followed by mucinous carcinoma (8.8 %), papillary carcinoma, medullary carcinoma and metaplastic carcinoma (2.9 %). In this study, the specificity, sensitivity, positive and negative predictive value, and diagnostic accuracy of fine-needle aspiration cytology were 100 %, 90 %, 100 %, 95 %, and 96 %, respectively. CONCLUSIONS FNAC of the breast lump is an easily performed outpatient diagnostic method for determining the nature of the breast mass. KEYWORDS FNAC, Fibroadenoma, Haematoxylin and Eosin, Infiltrating Ductal Carcinoma - Not Otherwise Specified (IDC NOS), May Grunwald Giemsa