Diagnostic Accuracy of Fine Needle Aspiration Cytology: Comparison of Results in Tabriz Imam Khomeini Hospital and Shiraz University of Medical Sciences

Introduction: It is more than 60 years that Fine Needle Aspiration (FNA) has been used for diagnosing palpable breast masses and has been known as an effective method for several years in Europe. In this study, we compared the diagnostic accuracy of FNA with open biopsy in Tabriz and Shiraz, Iran.

Material and Methods: We studied 100 patients with breast lesions in Tabriz Imam Khomeini Hospital from late September 2003 to late July 2004. FNA and open biopsy were done for all patients, FNA results were studied by pathologists in Tabriz imam Khomeini hospital and Shiraz University and pathological and cytological results were compared.

Results: According to cytology, 44% of samples were benign, 15% were suspicious, 33% were malignant and 8% were insufficient in Tabriz. These figures were 25%, 10%, 27% and 37%, respectively in Shiraz. Sensitivity of FNA was higher in Tabriz (89.79% vs. 69%) but specificity did not differ significantly in two groups (93.47% vs. 80.95%). Positive and negative predictive values were 97.77% and 89.36% in Tabriz and 100% and 60.6% in Shiraz, respectively. FNA accuracy was higher in Tabriz than in Shiraz (93.47% vs. 80.95%).

Conclusion: If done by experts, FNA can be a reliable replacement for open biopsy in palpable breast masses. Evaluation of FNA samples during aspiration can decrease insufficient samples. FNA (at least in deprived areas) can be the first line of diagnosis in women with breast masses and is helpful to increase health standards and clinical supervision of patients.