Performance of Fine-Needle Aspiration Cytology. of the Breast-Multicenter Study of 23,063 Aspirates in ten Italian Laboratories

Abstract

Although centers scored, on average, well within standards recommended by national authorities, this study suggests the opportunity of interlaboratory quality control to achieve more homogeneous criteria.

International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology: A Review of Predictive Values and Risks of Malignancy

“…Case studies of consecutive FNAB in centers have emphasized the diagnostic accuracy and do not usually distinguish breast carcinomas according to their histologic subtype. A large retrospective study from Italy evaluating more than 20,000 breast FNAB at multiple medical centers showed that the sensitivity was associated with histologic types of breast cancer, with lower sensitivity for intraductal carcinoma (77 vs. 92.9%, p < 0.00001) and lobular type compared to other types of invasive carcinoma (85.5 vs. 94%, p < 0.0025) [40]. …”

“…In a study of 1885 nonpalpable breast lesions, Boerner et al [36] found a ROM in cases reported as atypical of 52.9%, falling in between the ROM of suspicious (75.8%) and benign (3.7%). Using a definition close to the currently proposed definition of atypical breast cytology, that is, “minor atypias, not consistent with cancer though sufficient to advise open biopsy,” Ciatto et al [40] reported a PPV of 53.4% for atypical as an average in their multicenter retrospective study, compared to a PPV of 96.9% for malignant breast cytology. Aker et al [31] distinguished several atypical categories, atypical/probably benign with ROM of 0% ( n = 24), atypical/not otherwise specified with ROM of 75% ( n = 60) and atypical/probably malignant with ROM of 97% in their consecutive series of 733 breast FNAB with histologic follow-up.…”

“…The cellular contents can be distinguished between cystic and solid lesions and can be used to guide patient management [3]. The multicenter study by Ciatto et al [40] also reported marked variation in inadequacy rates between 10 test sites ranging from 0 to 11.6% for cancer cases, and up to 45.5% for benign cases. This supports the notion that standardized FNAB practice with accurate reporting is essential to establish trust in the diagnostic procedure [1].…”

Positive predictive value of breast fine needle aspiration cytology (FNAC) in combination with clinical and imaging findings: a series of 2334 subjects with abnormal cytology

“…In particular a C3 (atypical) or C4 (suspicious) report on FNAC [1,2], respectively associated with a 20-50% or 90-95% PPV, do not allow immediate treatment planning, usually need histological confirmation, and may cause unnecessary benign surgical biopsies. Relative to the histological information obtained through core biopsy, especially within the context of assessing screen-detected lesions, breast FNAC has thus become increasingly abandoned particularly in North America and the UK.…”

Ultraschallgesteuerte Schneidbiopsien nicht palpabler Mammaläsionen: Korrelation mit den Ergebnissen der ultraschallgesteuerten Feinnadelpunktion

“…Die Feinnadelpunktion (FNP) hat einen hohen Stellenwert in der Differentialdiagnose von palpablen Mammaläsionen [1] und wird auch zur Verbesserung der diagnostischen Sicherheit bei nicht palpablen Läsionen, alternativ stereotaktisch [2,3] oder US-gesteuert [4], eingesetzt. Die Vorteile der FNP sind insbesondere die mögli-che sofortige Diagnose, die minimale Kompromittierung des Tumorbetts bei malignen Läsionen und die im Vergleich geringen Kosten [5].…”