Evaluation of Breast Lump - Comparison between True-cut Needle Biopsy and FNAC in MMCH: A Study of 100 Cases.

One-fourth of all women suffer from breast disease in their lifetime. World Health Organization estimated that over 508,000 women died in 2011 due to breast cancer worldwide.For several years, fine needle aspiration cytology (FNAC) was the most practiced method for the pathological diagnosis of breast lump specially differentiation of benign from malignant. The advent of core needle or True-Cut biopsy (TCB) in the new millennium has resulted in many surgeons switching to TCB since it provides a sufficient amount of tissue for pathologists to make an accurate histological diagnosis.During the study period, patients present with clinically palpable breast lump admitted in different surgicalunits of MMCH, among them 100 patients selected purposively. Then a prospective comparative study was carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2017 to February 2018. Out of a total of 100 patients, who presented with suspicious breast lump, as clinically diagnosed 68 patients had benign breast lump and 32 patients had malignant breast lump. FNAC confirmed the diagnosis of breast carcinoma in 27 patients with sensitivity 89.65% and specificity 66.66%. True-cut biopsy confirmed the diagnosis of breast carcinoma in 29 patients with sensitivity 96.66% and specificity 100%. It also gave the definitive histological type and grade which correlated with the final histopathology report in 29 out of the 30 patientsTCB also provides adequate tissue for the evaluation of molecular markers which have extreme therapeutic value.

Skin Biopsy and Histopathological Diagnosis of Dermatological Diseases.

Microscopic examination of skin and mucous membrane is an established investigation in diagnosis and follow up of many dermatological conditions frequently encountered during practice. Histopathological examination is performed with biopsied specimen from skin and or mucous membrane where required. However neither do all skin biopsies produce neither a conclusive diagnosis nor the dermatologists routinely perform this procedure to every patient they consult. This cross sectional descriptive study conducted by reviewing the records of all biopsied cases studied for histopathology in Mymensingh Medical College, Mymensingh and Shaheed Mansur Ali Medical College, Dhaka, Bangladesh from January 2012 to December 2016. The aim of this study was to investigate the favourable clinical diagnoses set by dermatologists when performing skin biopsy, the diagnoses reached by the dermatopathologists after microscopic examination, and the relationship between them and finally to comment on the instances that skin biopsy fails to fulfill the diagnostic task. Fourteen hundred and thirty six (1436) cases of skin biopsy were reviewed and descriptive statistics were performed. Maximum cases 39.1% (562) were in 2nd decade with almost equal sex distribution. The most frequently proposed clinical diagnoses included papulosquamous dermatoses 28.6% (410), whereas histological confirmation was in 13.1% (188). Histological diagnosis was more as nonspecific dermatitis 31.6% (454). After microscopic examination, a specific histological diagnosis was found in 83.5% (1199) of the cases and a consensus between clinical and histological diagnoses was observed in 69.2% (994). Neither histological diagnosis nor any feature consistent with clinical suspicion was observed in 10.1% (145) cases. Histopathological examination of skin biopsy is still a valuable diagnostic tool in many skin diseases and dermatoses with diagnostic dilemma. There are cases in which diagnostic inefficiency are being faced even after skin biopsy examination.