Fine needle aspiration cytology in the management of male breast masses - Nineteen years of experience

OBJECTIVE: To determine the utility and accuracy of fine needle aspiration cytology (FNAC) as well as its sensitivity, specificity and predictive valu e in the diagnosis of male breast masses. STUDY DESIGN: Data on male breast FNAC done between 1978 and 1997 were retr ieved from the records of the cytopathology laboratory. FNAC diagnoses were categorized as positive, negative, inconclusive or unsatisfactory. Cytohis tologic correlation was done with data from histopathology records. Sensiti vity, specificity, diagnostic accuracy and predictive values of FNAC were c alculated using standard statistical methods. RESULTS: Five hundred seven of 13,175 patients undergoing breast FNAC were males. Of them, 393/507 had satisfactory aspirates. Of these, 70 were posit ive (13.8%), 295 were negative (58%), and 29 were inconclusive (5.7%). A to tal of 114 FNACs (22.5%) were unsatisfactory. Histopathology was available in 97/507 cases. There were no false positive or false negative diagnoses. FNAC had a sensitivity, specificity and diagnostic accuracy of 100% for mal e breast lesions. CONCLUSION: This large study shows that FNAC is a very accurate tool for di agnosis of male breast lesions. If is highly sensitive and specific, with g ood cytohistologic correlation. FNAC should therefore be an integral part o f breast lumps in males.