Publication:

Role of fine needle aspiration cytology in male breast lesion: 4 year observational study

Background Fine needle aspiration (FNA) is a well-established and widely accepted procedure in the evaluation of breast masses. However breast masses in males is rarely aspirated and hence there is limited cytopathologic experience. The aim of our study was to determine the efficacy of FNAC in the diagnosis of male breast lesions and also we attempted to describe the cytomorphological features of some of these lesions. Its advantages over other more invasive diagnostic methods, in terms of speed, cost effectiveness and low complication rate have made it a first line investigation for both diagnosis and management of breast lesions.

Methods Data on male breast FNAC done between June 2009 to June 2013 were retrieved from the records of the department of pathology. FNAC diagnoses were categorized as: C1 (Inadequate/ Insufficient) C2 (benign), C3 (Atypical /Indeterminate), C4 (Suspicious /probably malignant), C5 (malignant). Histopathological correlation done with subsequent surgical specimens wherever possible. Sensitivity, specificity and diagnostic accuracy were calculated using standard statistical methods.

Results 53 out of 2144 patients undergoing breast FNAC were males. Histopathology was available in 7 (13.20%) out of 53 cases. FNAC had a sensitivity of 80%, specificity of 100% and diagnostic accuracy of 85.71 % for male breast lesions.

Conclusions FNAC is a very accurate tool for the diagnosis of male breast lesions. It is less sensitive due to inadequate cellularity but when cellularity is adequate then it is 100% specific. To reduce the high rate of surgical biopsies of benign male breast masses, we conclude that FNAC should be performed as a standard procedure in the clinical evaluation of male breast lesions.