Diagnostic Accuracy of Scrape Cytology in Comparison to Histopathology in Neoplastic Breast Lesions: A Cross-sectional Study.

Introduction: Breast cancer is a predominant health issue among women, and has high morbidity and mortality rates. A diverse array of imaging techniques are available ranging from mammography and breast-specific gamma imaging to nanomedicine. Histopathological Examination (HPE) is the definitive standard for diagnosing breast lesions. The drawback of histopathology lies in its reliance on protracted processing methods, resulting in delayed reporting, rendering it unsuitable for intraoperative diagnosis where scrape cytology may serve as an option for early detection as well as treatment. Aim: To study the accuracy of scrape cytology in comparison to histopathology in neoplastic breast lesions. Materials and Methods: This cross-sectional study was conducted in the Department of Pathology, SGT Medical College Hospital and Research Institute, Gurugram, Haryana, India, for a period of two years from June 2022 to May 2024 This study included Fine Needle Aspiration Cytology (FNAC) confirmed 170 postoperative lumpectomy and mastectomy specimens for neoplastic lesions. All specimens were received in 10% neutral buffered formalin. Areas of growth were grossly identified and scraped with a scalpel. After cytological smear preparation the formalin fixed specimens were prepared for HPE and stained with Haematoxylin and Eosin (H&E) stains. The diagnostic accuracy of scrape cytology in comparison to histopathological diagnosis was done by Chi-square test. Results: Out of total 170 cases, 94 were found to be benign and 76 were found to be of malignant aetiology on scrape cytology, which was confirmed by HPE. In the study, 168 cases were diagnosed accurately with a diagnostic accuracy of 98.82%. Among the benign cases, fibroadenoma was the most common diagnosis, accounting for 74 cases. In the malignant group, Invasive Ductal Carcinoma (IDC) was the most frequent diagnosis, with 54 cases. Of 94 cases identified as benign in scrape cytology, 92 came out to be benign, and 02 cases were diagnosed as malignant on histopathology that included 01 case of malignant Phyllodes tumour and 01 case of lobular carcinoma. Conclusion: Scrape cytology was compared to HPE, which is considered the gold standard for diagnosis. Scrape can be utilised in resource-limited locations with no special instruments or equipment required compared to histopathology. Scrape is also helpful in studies where FNAC yields non diagnostic results and can improve interpretation skills of FNAC. [ABSTRACT FROM AUTHOR]

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