Empirical accuracy of fine needle aspiration cytology (FNAC) for preoperative diagnoses of malignant breast lumps in hospitals with restricted health resources

Abstract

Objective: To reevaluate the additional diagnostic value of FNAC from patient profiles in the diagnosis of breast cancer among patients presenting with breast lumps. Methods: A database was reconstructed from routine follow-up data of patients with breast diseases. Predictive ability of the variables were presented with an area under a receiver operating characteristic (ROC) curve using the logistic model. Results: Age and size of breast lumps alone could predict malignancy with a ROC area of 0.85, (95% CI = 0.81-0.89). When FNAC was added into the logistic model in the presence of age and size of breast lumps, the ROC area increased to 0.95 (95% CI = 0.93-0.97) with statistical significance. Given the same FNAC classification codes, the probability of malignancy increased in older patients and in patients with larger breast lumps. Conclusion: In developing countries where health resources are restricted, FNAC seems to be cost efficient. Continued use of the technique should be encouraged.