False-positive and false-negative cases of fine-needle aspiration cytology for palpable breast lesions

Ishikawa, Takashi; Hamaguchi, Yohei; Tanabe, Mikiko; Momiyama, Nobuyoshi; Chishima, Takashi; Nakatani, Yukio; Nozawa, Akio; Sasaki, Takeshi; Kitamura, Hajime; Shimada, Hiroshi

doi:10.2325/jbcs.14.388

Cited by 57 publications

(52 citation statements)

References 9 publications

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“…Fine needle Aspiration Cytology has been proved to be a highly efficacious method in diagnosis of palpable breast lesion in our study. The sensitivity of 98.07% and specificity of 100% obtained in our study were in accordance to sensitivity of 86-99% and specificity of 92-100% reported in various studies (Jayaram et al, 1996;Rubin et al, 1997;Argia et al, 2002;Hussain, 2005;Muhamed et al, 2005;Ishikawa et al, 2007).…”

Section: Discussionsupporting

confidence: 92%

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

Kochhar¹,

Jindal²,

Singh³

2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 92%

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

Kochhar¹,

Jindal²,

Singh³

2013

Asian Pacific Journal of Cancer Prevention

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“…False-negative and false-positive results occur due to physician experience 16,17 , sample quality 18 and certain histopathology diagnoses 19 . Using ultrasound guided FNAC increases specifi city and sensitivity of FNA 20,21 . False-positive and false-negative results can mislead clinicians and therefore FNA should not be used as the only diagnostic tool in diff erential diagnosis of breast tumors.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Fine Needle Aspiration Cytology for Breast Tumors

Mišković

Zorić

Mišković

et al. 2016

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SUMMARY -Breast cancer is the most frequently diagnosed cancer and the leading cause of death from cancer in women. Th e accuracy of diagnosis can be increased with a combination of clinical examination, imaging diagnostics, and fi ne needle aspiration cytology (FNAC) or core needle biopsy, also known as triple test. Th e aim of the study was to evaluate the sensitivity and specifi city of FNAC in the diagnosis of breast tumors in our institution by correlating it with histopathology fi ndings. We assessed the accuracy of 124 FNAC fi ndings by comparing cytological diagnosis of breast masses with the diagnoses from histopathology reports obtained by surgery. Statistical analysis showed 95.1% accuracy, 97.7% sensitivity, 89.1% specifi city, 95.5% positive predictive value and 94.2% negative predictive value of FNAC. Study results indicated that FNAC could be used as a highly reliable tool in the diff erential diagnosis of breast tumors, in combination with clinical and imaging fi ndings, especially in developing countries with limited fi nancial resources.

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“…These include: (1) technical difficulties where the smears are limited by cellularity or obscured by drying artifact and or blood, (2) inexperience or unfamiliarity of the pathologist with the cytologic features of breast FNAs and (3) the overlap of cytologic features of certain benign and malignant conditions due to the nature of the lesion (true gray zone) [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]. The first 2 factors have accounted for the majority (up to 80%) of C3 and C4 cases whereas the ‘true gray zone' represents a small fraction (20%) [9].…”

Section: Factors Contributing To the Indeterminate/erroneous Categorymentioning

confidence: 99%

“…Less common lesions include granular cell tumor, adenomyoepithelioma, lactation- and pregnancy-related lesions, fat necrosis, inflammatory and radiation changes, adenoid cystic carcinoma (ACC), spindle-cell lesions and Phyllodes tumor (PT) [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24]. …”

Section: Lesions Contributing To the Indeterminate/erroneous Categorymentioning

confidence: 99%

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

2013

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Objective: To review our experience and the literature on inconclusive/erroneous fine-needle aspirates (FNAs) of breast with the focus on the ‘true gray zone'. To describe the cytology, differential diagnosis, pitfalls and limitations of common and rare lesions. Study Design: We conducted a literature search focusing on breast FNAs with statistical data of C3 and C4 categories including false-positive and false-negative cases. Similar data from 2003 to 2009 was obtained from our institution. Results: C3 and C4 categories account for 3-17% of breast FNAs. Contributing factors are technical difficulties, inexperienced pathologists interpreting FNAs of breast and overlap of cytologic features of certain benign and malignant conditions; this last, ‘true gray zone' accounts for 2% of cases. Fibroadenoma, proliferative breast lesions, gynecomastia, infiltrating and in situ low-grade adenocarcinomas and tubular, cribriform, lobular and mucinous carcinomas are the most common problematic lesions. Granular cell tumor, adenomyoepithelioma, pregnancy-related lesions, fat necrosis, inflammatory and radiation changes, adenoid cystic carcinoma, spindle-cell lesions and Phyllodes tumor are less common. Conclusion: Inconclusive/erroneous FNAs of breast due to the ‘true gray zone' are rare. Most are due to the overlapping cytologic features of some benign and malignant conditions. Practical features that may help arrive at the correct diagnoses are elucidated.

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False-positive and false-negative cases of fine-needle aspiration cytology for palpable breast lesions

Abstract: Palpable breast tumors can be definitively diagnosed based on a combination of physical examination, radiological studies and FNA, when the radiological studies concur with the diagnosis by FNA.

Cited by 57 publications

References 9 publications

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

Diagnostic Value of Fine Needle Aspiration Cytology for Breast Tumors

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

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