Choosing between FNAC and Core Needle Biopsy: A Battle in Breast Carcinoma Diagnosis

The present study was conducted in a tertiary care teaching hospital to evaluate the role of FNAC and CNB in diagnosis of suspicious breast cancer by keeping mastectomies- surgical excision (SE) as gold standard. Breast cancer is the commonest female malignancy worldwide. The management of breast carcinoma relies heavily on the diagnostic parameters. Over the years there has been a steady decline in the usage of fine needle aspiration cytology (FNAC) over more popular core needle biopsy (CNB). This was a prospective study done in the department of Pathology of a tertiary care teaching hospital catering to the urban as well as rural population in northern part of India. A total of 60 patients were subjected to simultaneous on site FNAC and CNB. Histopathological correlation (SE) was available in half of the cases only (30 cases). While the Cytological grading was done according to Robinson grading system; the histopathological grading was done by Nottingham Modification of Scarff-Bloom Richardson method. FNAC diagnosed 29 cases whereas CNB diagnosed only 26 cases as malignant with 3 cases signed out as non-diagnostic for malignancy owing to non-sampling from the representative areas. On comparing, FNAC and CNB; agreement was not statistically significant (p=0.14) Comparison of CNB and SE; in 17 cases agreement were noted for both CNB and SE and statistically the values were highly significant (p=0.0001). On comparison of FNAC and SE in 13 cases agreement was noted for both FNAC and SE and the data was statistically significant (p=0.035). It is concluded that FNAC gives 100% results, it is quite reliable investigation and CNB should be done as an adjunct if needed especially for grading of the tumor and for immunohistochemistry.