DIAGNOSTIC ACCURACY OF FNAC AND CORE NEEDLE BIOPSY IN PALPABLE BREAST LUMPS: A META-ANALYSIS OF COMPARATIVE STUDIES

Abstract

BACKGROUND; Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy (CNB) are most widely used diagnostic procedures for the evaluation of palpable breast lumps. Despite being less invasive than CNB, FNAC´s diagnostic reliability remains inconsistent. By identification of relevant studies from current scientific literature, this meta-analysis aimed to evaluate the diagnostic accuracy of FNAC and CNB in suspicious breast lumps.

METHOD;  Various comparative studies on FNAC and CNB in diagnosing palpable breast lumps were included in this meta-analysis. Studies reporting on sensitivity, specificity, and diagnostic accuracy were included by carrying out a comprehensive literature search over databases of last 6 years. Forest plots were drawn to display the sensitivity and specificity of FNAC and CNB respectively.

RESULTS: The pooled sensitivity of FNAC ranged from 35% to 96.61%, while CNB consistently exhibited high sensitivity range of 82.86% to 100%. Similarly, FNAC specificity ranged from 48% to 100%, whereas CNB specificity was more consistent 86% to 100%, thus endorsing better histological differentiation between benign and malignant pathologies. The diagnostic accuracy of FNAC ranged from 71.4% to 96.6%, while CNB demonstrated higher and more consistent accuracy of 82.8% to 100%. False negatives were higher in the FNAC group, particularly in inflammatory breast pathologies, whereas CNB had minimal false negatives, ensuring greater diagnostic accuracy.

CONCLUSION; This meta-analysis concluded that CNB had got higher diagnostic accuracy, sensitivity, and specificity compared to FNAC in evaluation of palpable breast lumps.