Fine-Needle Aspiration Cytology (FNAC) is a reliable diagnostic tool for small breast lesions (≤ 1.0 cm): a 20-year retrospective study

Abstract

Background

Breast cancer is a major public health problem worldwide. It is recommended that small breast lesions or those suspicious for malignancy be evaluated via histopathological examination (“core biopsy” or surgical specimens), and lesions that are probably benign and palpable should be examined via fine-needle aspiration cytology (FNAC). This study aimed to assess the accuracy of FNAC for the diagnosis of small breast lesions.

Methods

We reviewed all anatomopathological reports of FNACs collected between January 1, 2000 and December 31, 2019 (n = 24,721) in a private community pathology service. Lesions up to 1.0 cm (≤1.0 cm) (n = 8334) were included for evaluation and classified according to the recommendation of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology in the following categories: (1) insufficient/inadequate; (2) benign; (3) atypical, probably benign; (4) suspicious of malignancy; and (5) malignant. Subsequently, the results of the FNACs were compared to those of the respective histopathological examinations (n = 785).

Results

FNAC had a specificity of 99.6%; sensitivity, 97.4%; positive predictive value, 99.6%; negative predictive value, 97.6%; and accuracy, 98.5%.

Conclusions

FNAC is a reliable method for diagnosing small breast lesions (≤1.0 cm).