Cyto-Histopathological Correlation of Breast Lump as a Part of Internal Quality Control

  • Shikha Goyal Assistant Professor, Department of Pathology, Ananta institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan
  • Manish Mewani Assistant Professor, Department of Pathology, Ananta institute of Medical Sciences and Research Centre, Rajsamand, Rajasthan
Keywords: FNAC; Breast lumps; Quality Control


Background: Breast malignancy is the most widely recognized tumor in females around the world. With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lesions has been revolutionized. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis.

Hence a review was undertaken with the following objectives.

  1. To correlate cytological and histopathological diagnosis of breast lesions as a part of internal quality control.
  2. To know the incidence of false positive and false negative cases.
  3. To find out the sensitivity and specificity of FNAC of breast lesions.

Methods: This study was conducted for a period of 2 year and 102 aspirations of breast lumps studied. Out of which 82 cases were followed- up by histopathological correlation.

Results: Cytological diagnosis in general was divided into four categories, benign (76.29%), malignant (18.29%), suspicious (2.44%), and unsatisfactory (00). Age of the patient was range from 16 - 62 years with mean age of 32 years. There were 76 female patients and 06 male patients. Fibroadenoma (54.87%) was most common benign neoplasm. The two cases which were categorized as “Epithelial Hyperplasia, Suspicious” by cytology turned out to be malignant lesions on histopathology. Sensitivity and specificity of FNAC in breast lesions were reported to be 88.24 % and 100% respectively, with 100% positive predictive value and 97.01% negative predictive value.

Conclusion: Considering the high specificity and sensitivity of aspiration cytology in the cases of breast lesion, it can be established as an internal quality control at tertiary centre to minimize economical stress demanded for EQAS (External Quality Assessment Scheme).


Download data is not yet available.


1. Orell SR, Stenett GF, Whitaker D. Chapter 7 breast. Fine needle aspiration cytology. 4th Ed. Churchill Livingstone; 2005.165-217.
2. F. Kamangar, G. M. Dores, and W. F. Anderson, ―Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world,‖ Journal of Clinical Oncology 2006; vol. 24(14):2137–2150.
3. American Cancer Society. Detailed Guide: Breast Cancer What are the key statistics for breast cancer? American cancer society cancer resource information
4. Tiwari M. Role of fine needle aspiration cytology in diagnosis of breast lumps. Kathmandu University Medical Journal (2007), Vol. 5, No. 2, Issue 18, 215-217
5. Kreuzer G, Bequoi E. Aspiration biopsy cytology, mammography and clinical Exploration; A modern set up in diagnosis of tumours of breast. Acta Cytol 1976;20:319–323.
6. Hermansen C, Poulsen HS, Jensen J. Diagnostic reliability of combined physical Examination mammography and fine needle puncture (‘’Triple-Test’’) in breast Tumours. Cancer 1987;16:1866–1871.
7. Owen DA, Tighe JR. Quality evaluation in histopathology. Br Med J 1975;1:149-50.
8. Zuk JA, Kenyon WE, Myskow MW. Audit in histopathology: Description of an internal quality assessment scheme with analysis of preliminary results. J Clin Pathol 1991;44:10-6.
9. Hocking GR, Niteckis VN, Cairns BJ, Hayman JA. Departmental audit in surgical anatomical pathology. Pathology 1997;29:418-21.
10. Lesna M. Assessing diagnostic errors: When is suspension of a pathologist justified? J Clin Pathol 1998;51:649-51.
11. Ramsay AD. Errors in histopathology reporting: Detection and avoidance, A review. Histopathology 1999;34:481-90.
12. Wang H.H., Ducatman B.S: — Fine needle aspiration of the breast: a probabilistic approach to diagnosis of carcinoma. Acta Cytol. 42(2): 285-289, 1998.
13. Ayata G., Abu-Jawdeh G.M., Fraser J.L., Garcia L.W., Upton M.P., Wang H.H. — Accuracy and consistency in application of a probabilistic approach to reporting breast fine needle aspiration. Acta cytol. 47(6): 973-978, 2003.
14. Tiwari M: Role of fine needle aspiration cytology in diagnosis of breast lumps. Kathmandu Univ Med J (KUMJ); 2007; 5: 215-217
15. Aditya khemka, N. Chakrabarti, S. Shah and Vitthal Patel, palpable breast lump: fine needle aspiration cytology versus histopathology: a correlation of diagnostic accuracy. The internal journal of surgery;2009,vol.18,No.1.
16. Ramesh S. Waghmare, Shubhangi D. Sakore, S. B. Rathod: Fine needle aspiration cytology of breast lesions and correlation with histopathology. Int J Res Med Sci;2016;4:4416-21.
17. Bojia F, Demisse M, Dejane A, Bizuneh T: Comparison of fine-needle aspiration cytology and excisional biopsy of breast lesions. East Afr Med J; 2001; 78: 226-228.
18. Watson DP, McGuire M, Nicholson F, Given HF: Aspiration cytology and its relevance to the diagnosis of solid tumors of the breast. Surg Gynecol Obstet; 1987;165: 435-41.
19. Clive SG, John RG, Jonh SW, Martin KJ. ‘’Fine needle aspiration of the breast.’’ Mayo Clin Proc 1986;61:377– 381.
20. Pandit AA, Mayekar KS, Candes FP. Fine needle aspiration cytology of the breast Tumour. Ind J Cancer 1988;25:136–143.
21. Kline TS, Joshi LP, Neal HS. ‘’Fine needle aspiration of the breast: diagnosis and pitfalls; a review of 3545 cases. ‘’ Cancer 1979;44:1458–1464.
22. Wanebo HJ, Feldman PS, Wilhelm MC, Covell JL, Binns RL. Fine needle aspiration Cytology in lieu of open biopsy in management of primary breast cancer. Ann Surg 1984;199:569 – 578
23. Norton LW, Davwis JR, Weins JL, Trego DC, Dunnington GL. ‘’Accuracy of aspiration cytology in detecting breast cancer.’’ Surery 1984;96:816–811.
24. Purasiri P, Abdalla M, Heys SD, Ah-See AK, McKean ME, Gilbert FJ, et al. A novel diagnostic index for use in the breast clinic. J R Coll Surg Edinb. 1996; 41: 30- 34.
25. Kaufman Z, Shpitz B, Shapiro M, Rona R, Lew S, Dinbar A. Triple approach in diagnosis of dominant breast masses: combined physical examination, mammography and fine-needle aspiration. J Surg Oncol. 1994; 56: 254-57.
26. Haddad FS. Re: Risk factors for perineal seeding of prostate cancer after needle biopsy. J Urol. 1990; 143: 587-88
How to Cite
Goyal S, Mewani M. Cyto-Histopathological Correlation of Breast Lump as a Part of Internal Quality Control. IABCR [Internet]. 29Jun.2018 [cited 20Aug.2018];4(2):87-0. Available from: