A Comparative Study Between FNAC, TRUCUT Biopsy and Histopathological Examination in Breast Lumps

Background: Palpable breast lumps are a common clinical presentation and may represent benign or malignant pathology. Accurate preoperative diagnosis is essential for appropriate treatment planning. Fine needle aspiration cytology (FNAC) and Tru-cut biopsy are widely used diagnostic modalities, with histopathological examination (HPE) serving as the reference standard. Aim: To evaluate the diagnostic accuracy of FNAC and Tru-cut biopsy in differentiating benign from malignant palpable breast lesions and to correlate their findings with final histopathology. Materials and Methods: A prospective cross-sectional study was conducted among 220 female patients aged above 14 years presenting with palpable breast lumps in the Department of General Surgery, GGH Guntur, from April 2024 to September 2025. Patients underwent clinical assessment followed by FNAC and/or Tru-cut biopsy. The findings were compared with postoperative histopathological reports. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were assessed. Results: Histopathology confirmed malignancy in 167 (75.9%) patients and benign lesions in 53 (24.1%). The upper outer quadrant was the most frequently involved site (36.3%). Invasive ductal carcinoma was the predominant malignant lesion, accounting for 144 (86.2%) cases. Among benign lesions, fibrocystic disease was the most common diagnosis (49%), followed by fibroadenoma (37.7%). FNAC identified 160 malignant lesions and had a reported sensitivity of 93%, specificity of 93%, PPV of 97%, and NPV of 90%. Tru-cut biopsy identified 165 malignant lesions, with a sensitivity of 97%, specificity of 99%, PPV of 99%, and NPV of 95%. The reported diagnostic accuracy was 94% for FNAC and 98% for Tru-cut biopsy. Tru-cut biopsy also demonstrated a lower inadequate sampling rate. Conclusion: Both FNAC and Tru-cut biopsy are useful in the evaluation of palpable breast lumps. FNAC provides a rapid and minimally invasive preliminary diagnosis, while Tru-cut biopsy demonstrates higher diagnostic accuracy and provides histological information useful for treatment planning. The triple assessment approach remains essential for reliable diagnosis. Keywords: Palpable breast lump; FNAC; Tru-cut biopsy; Histopathological correlation.