Enhancing Diagnostic Accuracy in Breast Pathology: Insights from a Meta-Analyses of FNAC and TCB

Background: The Fine Needle Aspiration Cytology (FNAC) and Tru-Cut Biopsy (TCB) are significant investigative techniques used to differentiate breast issues. There is much research done on how well the two techniques complement each other. Aim and objective: The systematic review and meta-analyses aimed to compare the diagnostic accuracy, sensitivity, and specificity of FNAC with TCB in breast pathology by conducting a meta-analysis of ten studies from 2017 to 2024 and answer the question: “How far we can trust FNAC alone in the diagnosis of breast lump alone? What are the cases when we can opt for FNAC alone or combine it with TCB and how do we individualize each case?”. Methods: The systematic literature review and meta-analyses using various databases, including PubMed, Scopus, and Embase were performed. Predesigned criteria-based studies were retrieved, with special emphasis on comparing FNAC with TCB in breast lesions. Data were retrieved for sample size evaluation, diagnosis outcomes, and tissue analysis correlations. Finally, ten studies were included. Results: The research found that TCB was more sensitive (average %) and specific (average %) compared with FNAC (average sensitivity %, specificity %). TCB also indicated fewer unsatisfactory specimens and misdiagnoses, especially with ductal carcinoma in situ (DCIS). Conclusions: TCB is more precise than FNAC in the diagnosis of breast lesions, especially regarding sensitivity and specificity. The evidence is in favor of recommending TCB as a first-line diagnostic test in clinical practice, especially in suspicious breast masses. However, the two techniques complement each other and proved to be crucial in the effective diagnosis of the condition.