Utility of Pattern Analysis in Breast Lesions and their Systematic Categorisation Based on Fine Needle Aspiration Cytology

Abstract

Introduction: Fine Needle Aspiration Cytology (FNAC) has its definite value in the diagnosis of various mass lesions including breast lesions. Pattern is a regular and intelligible form or sequence discernible in the way which suggests a particular lesion. Patterns observed on cellular morphology in the aspirate are limited and need categorisation, as the risk of malignancy differs with the patterns. Aim: To study and analyse patterns of various breast lesions on FNAC. To categorise various breast lesions according to patterns. Also, to compare sensitivity and specificity of different patterns with histopathology as a gold standard and to assess risk of malignancy in individual patterns. Materials and Methods: This was a retrospective and prospective study in which patterns of various breast lesions on FNAC were studied. The data of 800 patients attending the OPD and IPD of Indira Gandhi Government Medical college Nagpur, over a period of 3 years (2015-2017), was analysed. The patterns evaluated were biphasic, inflammatory, fluid rich, epithelial cell rich, spindle cell rich, small round cell rich and pleomorphic. Results: The lesions were classified as per patterns followed by evaluation of accuracy and risk of malignancy associated with each pattern. We found that the risk of malignancy varies with patterns. Conclusion: Systematic pattern analysis and systematic categorisation of the breast lesions as per patterns, assists the cytopathologists to reach the final impression. Each pattern has its own implications for management and has a variable risk of malignancy

Keywords

• intelligible
• reproducible
• triple test