Comparative Analysis of the Diagnostic Accuracy of Fine-Needle Aspiration Cytology (FNAC) Versus True-Cut Biopsy in the Detection of Malignancy Within Detectable Breast Masses.

Abstract

Background: Breast cancer remains the prevailing malignancy affecting women universally and is a leading contributor to cancer-related fatalities among the female population, with a significant burden in developing nations. Objective: This research aimed to evaluate the diagnostic precision of needle aspiration Cytology (FNAC) in the identification of malignancy within palpable breast lumps. A parallel objective was to conduct a comparative analysis with a Tru-Cut biopsy. Study design: An analytical cross-sectional study Place and Duration: This study was conducted in Peoples University of medical and Health sciences for women Nawabshah from May 2022 to May 2023 Methodology: The inclusion criteria encompassed patients visiting the hospital's breast clinic who presented with detectable breast lumps. Histopathological evaluations were performed on specimens procured via FNAC, Tru-Cut biopsy, and excisional biopsy. Subsequent application of Hematoxylin and Eosin (H&E) staining facilitated the histological examination of both the Tru-Cut biopsy and tissue samples from the excision procedures. Results: Out of the 110 cases under investigation, malignancy was identified in 31.82% (n=35). The diagnostic precision of Tru-Cut biopsy in detecting cancer within patients displaying palpable breast lumps, with histopathology examination after excision biopsy (HPE) as the gold standard It demonstrated a sensitivity of 82.86%, a specificity of 95.24%, a positive predictive value (PPV) of 88.57%, a negative predictive value (NPV) of 92.31%, and an accuracy rate of 89.09%. The calculated likelihood ratio was 19.75. Conversely, FNAC biopsy's diagnostic accuracy in detecting malignancy within palpable breast lumps, utilizing HPE as the reference standard, yielded a sensitivity of 71.43%, a specificity of 92.68%, a PPV of 80.95%, NPV of 85.71%, and an accuracy rate of 81.82%. The calculated likelihood ratio was 10.21. Conclusion: Regarding the diagnosis of cancer within patients presenting palpable lumps in the breast, both FNAC and Tru-Cut biopsy demonstrate commendable diagnostic accuracy. However, Tru-Cut biopsy exhibits heightened accuracy in comparison to FNAC for detecting this pathological condition.