Presentation and diagnostic accuracy of fine-needle aspiration cytology and ultrasonography in detecting breast cancer in tribal females of rural West Bengal

Abstract

Sanhita Mukherjee, Sunanda De, Sarbari Swaika, Diptakanti Mukhopadhyay

Background: The present study tried to have a comparative analysis of the sensitivity, specificity and positive predictive value (PPV) of ultrasonography (USG) and fine needle aspiration cytology (FNAC) in the detection of breast cancer among a tribal population. Materials and Methods: Ninety two tribal females attending surgical outdoor with breast lumps were included in the study. Their demographic parameters, the mode of presentation, time lapse since first noticed, presence and absence of wellknown breast cancer risk factors were studied. All patients were subjected to FNAC and USG and the findings of these two investigations were compared with the histopathology reports when the patients came for a follow-up. Data were analyzed using the statistical package for social sciences software version 17 for Windows. Percentage, sensitivity, specificity, and positive predictive values (PPV) were calculated. Results: Among 92 patients 68 (74%) were diagnosed to have benign breast disease and 24 (26%) had carcinoma breast. Although the age of presentation of these patients did not differ from that of the western population, the time lapse since first noticed and the prevalence of well-known risk factors of breast cancer such as, parity and the usage of oral contraceptive pills differed markedly in the study group. The sensitivity, specificity and PPV of ultrasonography were 91.67%, 91.18% and 78.58% respectively and that of FNAC was found as 95.83%, 97% and 92%. Conclusion: The study observed a late presentation of breast lump in tribal rural women of Bankura, West Bengal. Nevertheless, the accuracy of the screening procedures like USG and FNAC are comparable with that of the Western World.