背景与目的大多数乳腺疾病表现为可触及的肿块。结合临床检查可提高其诊断的准确性,乳房X线照相术,细针穿刺细胞学(FNAC),术前进行芯针活检(CNB)。乳腺肿块的FNAC或CNB的最终目的是在术前确认癌症的诊断,这可能有助于避免良性疾病的不必要手术。组织病理学是建立乳腺肿块诊断的金标准。在这项研究中,我们的目的是比较灵敏度,特异性,阳性预测值(PPV),负预测值(NPV),FNAC与Trucut活检的诊断准确性,并提供FNAC和CNB对可疑乳腺恶性肿瘤切除乳腺肿块的最终组织病理学诊断的联合评估。材料和方法这是一个前瞻性的,观察,为期一年的横断面研究,涉及42例疑似乳腺癌患者接受FNAC,CNB,手术切除后进行组织病理学检查。收集数据,并在灵敏度方面进行分析,特异性,PPV,NPV,与组织病理学相比,FNAC和CNB的诊断准确性。结果研究中的大多数患者(78.6%)年龄在31-50岁之间。在我们的研究中,FNAC表现出敏感性,特异性,PPV,NPV,诊断准确率为74.1%,76.9%,87.0%,64.7%,分别为75%。CNB有一种敏感性,特异性,PPV,NPV,诊断准确率为85.2%,92.8%,95.8%,76.5%,分别为87.8%。两种模式(FNAC和CNB)之间的一致性水平中等且具有统计学意义(k=0.543;p<0.001)。在FNAC和CNB针对恶性肿瘤/临界诊断的最终组织病理学诊断的联合评估中,灵敏度,特异性,PPV,NPV,诊断准确率为89.3%,85.7%,92.6%,80%,分别为88.1%。结论FNAC和CNB联合评估对恶性肿瘤/临界诊断的最终组织病理学诊断的诊断准确性优于FNAC或CNB。这一发现表明,这两种技术是相辅相成的。FNAC和CNB分别作为病理诊断的一线和二线方法。
Background and objective Most breast diseases present as palpable lumps. The accuracy of their diagnosis can be enhanced by a combination of clinical examination, mammography, fine-needle aspiration cytology (FNAC), and core needle biopsy (CNB) preoperatively. The ultimate aim of FNAC or CNB of the breast mass is to confirm the diagnosis of cancer preoperatively, which may help avoid unnecessary surgeries for benign conditions. Histopathology is the gold standard to establish the diagnosis of a breast mass. In this study, we aimed to compare the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of FNAC with those of trucut biopsy, and provide a combined assessment of FNAC and CNB against the final histopathological diagnosis of excised breast mass in suspected breast malignancies. Materials and methods This was a prospective, observational, cross-sectional study conducted for a duration of one year involving 42 patients with suspected breast cancer cases who underwent FNAC, CNB, and surgical excision followed by a histopathological examination. Data were collected and analyzed in terms of sensitivity, specificity, PPV, NPV, and diagnostic accuracy of FNAC and CNB in comparison with histopathology. Results The majority of the patients in the study (78.6%) were in the age group of 31-50 years. In our study, FNAC showed a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 74.1%, 76.9%, 87.0%, 64.7%, and 75% respectively. CNB had a sensitivity, specificity, PPV, NPV, and diagnostic accuracy of 85.2%, 92.8%, 95.8%, 76.5%, and 87.8% respectively. The level of agreement between the two modalities (FNAC and CNB) was moderate and statistically significant (k=0.543; p<0.001). In the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 89.3%, 85.7%, 92.6%, 80%, and 88.1% respectively. Conclusion The diagnostic accuracy of the combined assessment of FNAC and CNB against final histopathological diagnosis for malignancy/borderline diagnosis was better than that of FNAC or CNB alone. This finding shows that both the techniques complement each other. FNAC and CNB are used as the first- and second-line methods of pathological diagnosis respectively.