Positive predictive value of the breast FNAB diagnoses of epithelial hyperplasia with atypia, papilloma, and radial...

Proliferative breast lesions are a spectrum of lesions that have overlapping cytological features and are difficult to subclassify in fine-needle aspiration biopsies (FNABs). This study of breast FNABs from the period of 1997-2001 aimed to correlate the cytological diagnoses of epithelial hyperplasia with atypia (EHA), papilloma (PAP), and radial scar/complexing sclerosing lesions with relevant histological follow-up, and to assess the positive predictive value (PPV) of the cytological diagnosis. The PPV for the three categories were found to be 0.16, 0.74, and 0.63 respectively. The low value observed in the cytological category of EHA was due to the heterogeneous nature of the group, which makes it difficult to correlate cytological appearances with the varying histological lesions. However, it was found that 70% of these EHA cases had benign histological diagnoses, matching the expected outcome. The PPV of 0.74 for the cytological diagnosis of PAP of the breast compares favorably to similar published studies, and we suggest that the specific diagnosis of PAP can be made reliably using cytological criteria.