Role of fine‐needle aspiration biopsy in breast lesions: Analysis of a series of 4,110 cases

• Published in: Diagnostic cytopathology 1998-06, Vol.18 (6), p.462-467
• Main Authors: Arisio, Riccardo, Cuccorese, Consuelo, Accinelli, Grazia, Mano, Maria Piera, Bordon, Rita, Fessia, Luciano
• Format: Article
• Language: English
• Subjects: Biopsy, Needle; breast cancer detection costs; breast neoplasms; Breast Neoplasms - classification; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; Carcinoma in Situ - diagnosis; Carcinoma in Situ - pathology; Carcinoma, Ductal, Breast - diagnosis; Carcinoma, Ductal, Breast - pathology; cell block; Female; Fibroadenoma - diagnosis; Fibroadenoma - pathology; fine‐needle aspiration biopsy; Humans
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/(SICI)1097-0339(199806)18:6<462::AID-DC16>3.0.CO;2-F

From January of 1990 to December of 1992, 6,954 consecutive cytologic breast fine‐needle aspiration biopsies (FNAB) were performed at the Laboratory of Pathology of Sant'Anna Hospital in Turin. Of these cases 62% were solid nodes, 35% were cystic nodes, and 2.7% were nonpalpable breast lesions (stereotaxic or ultrasound guided FNAB). We verified 4,110 cases: 913 cases underwent surgery and 3,197 were evaluated clinically, and/or cytologically, and/or with mammography at least 1 yr after the first diagnosis, or checked with the database of the Tumor Registry of Turin. In our series the FNAB sensitivity was 94.6%, specificity was 99.9%, accuracy was 98.8%, inadequate samples were 6.4%, false‐negative rate was 1.4%, and false‐positive rate was 0.3%. Our results indicate that the use of cell block improves sensitivity (from 85.2 to 94.6%) and strongly reduces false‐negative results (from 3.9 to 1.4%). We conclude that FNAB is a discriminant procedure to the surgical biopsy in cases with clinical, ultrasound, or mammographic low or intermediate suspect, contributing to allow a high malignant/benign surgical biopsy rate and to reduce the need for frozen section diagnosis and medical costs. Diagn. Cytopathol. 1998;18:462–467. © 1998 Wiley‐Liss, Inc.