The study of role of mammography and fine needle aspiration cytology in the diagnosis of early breast carcinoma


  • Biju Stephen Department of General Surgery, T. D. Medical College Hospital, Alappuzha, Kerala, India
  • Manoj V. V. Department of General Surgery, T. D. Medical College Hospital, Alappuzha, Kerala, India



Breast cancer, FNAC, Mammography, Histopathology, Breast lump, Sensitivity, Specificity, Accuracy


Background: Epidemiologically breast cancer is the most common form of cancer among women. Prevalence rate of breast cancer is higher in urban women of middle age group. Early diagnosis of breast carcinoma is required for effective treatment else it may lead to mortality if advanced to stage 3 or 4. At present, there are different diagnosis modalities for early stage breast carcinoma. Currently triple diagnostic assessment including clinical, radiological and pathological examinations with 99% sensitivity is used in diagnosing all palpable breast lumps. The aim of the study was to determine the sensitivity and specificity of mammogram and Fine needle aspiration cytology (FNAC) in diagnosing breast cancer.

Methods: A cross sectional study was conducted on total 80 female patients above 30 years of age with a palpable breast lump. Patients were sent for mammography, fine needle aspiration cytology and histopathological examinations. Results of mammography, FNAC and HPR were compared and statistically correlated.

Results: Sensitivity of mammogram diagnosis was observed to be 92.857%, specificity as 86.842%, positive and negative predictive values to be 88.636% and 91.667% respectively. Therefore, current study findings revealed accuracy of mammogram to be 90.000%. Sensitivity of FNAC diagnosis was observed to be 92.857% and specificity to be 100%, positive and negative predictive values were observed to be 100% and 92.683% respectively. The study results revealed that FNAC diagnosis exhibited accuracy of 96.250%.

Conclusions: Current investigation findings revealed that FNAC has more accuracy in predicting breast cancer than mammogram. Also, it was concluded that there is a significant association between FNAC and mammogram diagnosis.



Mattiuzzi C, Lippi G. Current Cancer Epidemiology. J Epidemiol Glob Health. 2019;9(4):217-22.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34.

Momenimovahed Z, Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer. 2019 Apr 10;11:151-64.

Coughlin SS. Epidemiology of Breast Cancer in Women. Adv Exp Med Biol. 2019;1152:9-29.

Malvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13(4):289-95.

Manoharan N, Nair O, Shukla NK, Rath GK. Descriptive Epidemiology of Female Breast Cancer in Delhi, India. Asian Pac J Cancer Prev. 2017;18(4):1015-8.

Waks AG, Winer EP. Breast Cancer Treatment: A Review. JAMA. 2019;321(3):288-300.

Hachem G, Gombos A, Awada A. Recent advances in understanding breast cancer and emerging therapies with a focus on luminal and triple-negative breast cancer. Res. 2019;8:591.

Akram M, Iqbal M, Daniyal M, Khan AU. Awareness and current knowledge of breast cancer. Biol Res. 2017;50(1):33.

Moo TA, Sanford R, Dang C, Morrow M. Overview of Breast Cancer Therapy. PET Clin. 2018;13(3):339-54.

Elmore JG, Armstrong K, Lehman CD, Fletcher SW. Screening for breast cancer. JAMA. 2005;293(10):1245-56.

Fletcher SW, Elmore JG. Clinical practice. Mammographic screening for breast cancer. N Engl J Med. 2003;348(17):1672-80.

Gartlehner G, Thaler K, Chapman A, Kaminski HA, Berzaczy D, Noord MG, et al. Mammography in combination with breast ultrasonography versus mammography for breast cancer screening in women at average risk. Cochrane Database Syst Rev. 2013;2013(4):9632.

Champaign JL, Cederbom GJ. Advances in breast cancer detection with screening mammography. Ochsner J. 2000;2(1):33-5.

Bassett LW, Manjikian V, Gold RH. Mammography and breast cancer screening. Surg Clin North Am. 1990;70(4):775-800.

Kazi M, Suhani, Parshad R, Seenu V, Mathur S, Haresh KP. Fine-Needle Aspiration Cytology (FNAC) in Breast Cancer: A Reappraisal Based on Retrospective Review of 698 Cases. World J Surg. 2017;41(6):1528-33.

Rahman MZ, Sikder AM, Nabi SR. Diagnosis of breast lump by fine needle aspiration cytology and mammography. Mymensingh Med J. 2011;20(4):658-64.

Smith MJ, Heffron CC, Rothwell JR, Loftus BM, Jeffers M, Geraghty JG. Fine needle aspiration cytology in symptomatic breast lesions: still an important diagnostic modality? Breast J. 2012;18(2):103-10.

Panwar H, Ingle P, Santosh T, Singh V, Bugalia A, Hussain N. FNAC of Breast Lesions with Special Reference to IAC Standardized Reporting and Comparative Study of Cytohistological Grading of Breast Carcinoma. J Cytol. 2020;37(1):34-9.

Mendoza P, Lacambra M, Tan PH, Tse GM. Fine needle aspiration cytology of the breast: the nonmalignant categories. Pathol Res Int. 2011;2011:547580.

Shetty MK, Shah YP, Sharman RS. Prospective evaluation of the value of combined mammographic and sonographic assessment in patients with palpable abnormalities of the breast. J Ultrasound Med. 2003;22(3):263-8.

Martelli G, Pilotti S, Yoldi G, ViganottiG, Fariselli G, Lepera P, et al. Diagnostic efficacy of physical examination, mammography, fine needle aspiration cytology (Triple test) in solid breast lumps: An analysis of 1708 consecutive cases. Tumouri. 1990;76(5):476-9.

Kaufman Z, Shpitz B, Shapiro M, Rona R, Lew S, Dinbar A. Triple approach in the diagnosis of dominant breast masses: combined physical examination, mammography, and fine-needle aspiration. J Surg Oncol. 1994;56(4):254-7.

Steinberg JL, Trudeau ME, Ryder DE, Fishell E, Chapman JA, Cready DR, et al. Combined fine-needle aspiration, physical examination and mammography in the diagnosis of palpable breast masses: their relation to outcome for women with primary breast cancer. Can J Surg. 1996;39(4):302-11.

Yang WT, Mok CO, King W, Tang A, Metreweli C. Role of high frequency ultrasonography in the evaluation of palpable breast masses in Chinese women: alternative to mammography? J Ultrasound Med. 1996;15(9):637-44.

Reinikainen HT, Rissanen TJ, Piippo UK, Päivänsalo MJ. Contribution of ultrasonography and fine-needle aspiration cytology to the differential diagnosis of palpable solid breast lesions. Acta Radiol. 1999;40(4):383-9.

Ariga R, Bloom K, Reddy VB, Kluskens L, Francescatti D, Dowlat K, et al. Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation. Am J Surg. 2002;184(5):410-3.






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