Diagnostic Accuracy of Ultrasound in Evaluation of Breast Lump in Correlation with FNAC

Open Access

Abstract

Introduction: Breast lumps are among the most common clinical presentations encountered in surgical practice. Ultrasonography is a widely used, non-invasive, and cost-effective imaging modality that plays a crucial role in the initial assessment of palpable breast lumps, while fine-needle aspiration cytology (FNAC) provides valuable cytological confirmation. The present study was conducted to assess the diagnostic accuracy of ultrasonography in palpable breast lumps by correlating its findings with FNAC. Methods & Materials: This cross-sectional study was conducted in the Department of Radiology & Imaging, Popular Medical Centre Limited Sylhet, Bangladesh from January 2025 to December 2025. A total of 104 consecutive patients presenting with clinically palpable breast lumps were enrolled using purposive sampling. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0. Result: Among the 104 patients included in the study, fibroadenoma was the most common breast lesion on both ultrasonography (44.2%) and FNAC (Fine Needle Aspiration Cytology) (42.3%), while malignant lesions accounted for 21.2% and 22.1% of cases, respectively. Ultrasonography showed excellent agreement with FNAC (κ = 0.86, p < 0.001) and demonstrated high diagnostic performance, with a sensitivity of 87.0%, specificity of 97.5%, positive predictive value of 90.9%, negative predictive value of 96.3%, and an overall diagnostic accuracy of 95.2%. BI-RADS categories were significantly associated with FNAC findings (p < 0.001), with the likelihood of malignancy increasing progressively from BI-RADS 2 to BI-RADS 5. Conclusion: Ultrasonography seems to show high diagnostic accuracy in the assessment of palpable breast lumps when compared with FNAC, exhibiting excellent concordance and effective discrimination between benign and malignant lesions. Being a non-invasive, widely accessible, and cost-effective imaging technique, ultrasonography is a valuable first-line diagnostic modality. Its complementary use with FNAC improves diagnostic precision, supports timely diagnosis, and aids clinicians in selecting appropriate management strategies for patients presenting with breast lumps.