Abstract:

Objectives: Fine needle aspiration (FNA) continues to be an acceptable and reliable procedure for the preoperative diagnosis of breast lesions, particularly. The purpose of this study is to evaluate our performance with FNA cytopathology (FNAC) in specific subtypes of (lobular, papillary, medullary, mucinous, tubular and other) breast carcinomas. Methods: FNAC results of specified carcinomas of breast, cyto-diagnosed and subsequently biopsied in 2006-2011 were compared with final histopathological evaluation. The results of FNAC were interpreted as benign, atypical, suspicious, malignant and non-representative. The absolute and complete sensitivity rates, underestimation of malignancy rate and inadequacy rate of FNAC were correlated with histopathologic subtype. Results: Of cyto-histopathologically correlated 60 cases, 59 (98.3%) were females and 1(1.7%) was a male. Age range was 34-83 years with a mean value of 58.5(±13.3). Mean age was significantly lower (49) in medullary carcinoma patients. Of cases, 1(1.7%) was diagnosed as benign (C2), 5(8.3%) were atypical (C3), 10(16.7%) were suspicious (C4), 37(61.7%) were malignant (C5) and 7(11.7%) were inadequate (C1) by cytopathology. Of specified histopathologic subtypes, 36(60.0%) lobular, 8 papillary, 7 medullary, 5 mucinous, 3 tubular and 1 adenoid cystic carcinomas were included. Invasive lobular-type carcinomas had lower (52.8% absolute (C5)); 69.5% complete (C5+C4) sensitivity rates. The complete sensitivity rate was 100% in papillary, medullary, mucinous and tubular carcinomas. The underestimation of malignancy rate (13.9%) and false negativity (2.8%) was higher in lobular carcinomas while tubular carcinomas showed a higher inadequacy rate (33.3%). Conclusion: For FNAC of the breast in the preoperative diagnosis of specified breast carcinomas, lobular and tubular carcinoma subtypes limit cytodiagnostic yield of FNAC. As management of breast diseases necessitates triple approach (clinical, radiological, pathological), an awareness of the FNAC limitations by all specialists is important, especially when dealing with specified breast carcinomas to decrease false-negative and false-positive results. 

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