Problems in Fine-Needle Aspiration Biopsy Cytology of Clinically or Mammographically Uncertain Breast Tumors

Pilotti, Silvana; Rilke, F; Delpiano, Chiara; S, Di Pietro; Guzzon, A

doi:10.1177/030089168206800509

Cited by 29 publications

(12 citation statements)

References 20 publications

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“…The impression that such continuity could give better results was confirmed by other investigators. [15][16][17]20 A cytologic diagnosis of suspicious should be an indication to repeat FNAB. 12,15 Our data indicate that this procedure may be contributory and costeffective 4 in preoperative diagnostic assessment of the lesion.…”

Section: Discussionmentioning

confidence: 99%

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Fine Needle Aspiration Biopsy of Breast Lesions and Histopathologic Correlation

Rocha

Nadkarni²,

Menezes³

1997

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

“…4,5 The values obtained were compared analytically with those given in some published papers. 1,2,4,5,12,16,17,20,24,25 In 9 of the 11 series analyzed, 1,2,11,20,21,24,25 data concerning diagnostic ac-…”

Section: Methodsmentioning

confidence: 99%

Fine Needle Aspiration Biopsy of Breast Lesions and Histopathologic Correlation

Rocha

Nadkarni²,

Menezes³

1997

Acta Cytologica

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“…Cytological smears were examined by the same team of one cytologist and one cytopathologist. The techniques of preparation, fixation, and staining of smears were similar to previously described methods [4]. Whenever the aspirate was fluid, smears were made after centrifugation.…”

Section: Methodsmentioning

confidence: 99%

The role of fine needle aspiration in the diagnosis of thyroid nodules: Analysis of 795 consecutive cases

Piromalli

Martelli

Prato

et al. 1992

Journal of Surgical Oncology

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The utility of fine needle aspiration (FNA) and physical examination for selecting patients with palpable thyroid nodules for surgery was evaluated in 795 consecutive cases. Surgery was performed in 216 patients based upon the cytological diagnosis and clinical criteria. Excluding 42 patients who were lost to follow-up, the remaining 537 were regularly followed up (range, 2-10 years). Cytological findings were classified as malignant, histologic control recommended (suspicious), follicular tumor, benign, and unsatisfactory. Thirty-six aspiration biopsies were positive for malignancy and the diagnosis was confirmed histologically in 34 of them. In 65 patients with final histological diagnosis of malignancy, cytology was positive in 34, suspicious in 20, benign in 3 cases, and unsatisfactory in 8. All patients with cytological diagnosis of follicular tumor had a benign lesion at histology. There were two false positive and three false negative cytological results among the 216 histologically confirmed cases. Excluding unsatisfactory specimen sensitivity, specificity and the predictive value for a positive and a negative result were respectively 95%, 97.5%, 94.5%, and 97%. We conclude that FNA is a very reliable diagnostic test in the evaluation of thyroid nodules and is the best guidance in addition to clinical criteria for selecting patients to be submitted to surgery.

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“…may be nondiagnostic due to scant cellularity or poor preparation when performed without immediate on-site interpretation. [1][2][3][4][5][6][7][8][9][10][11] On-site evaluation of FNA specimens can be beneficial in determining adequacy: triage of specimens for ancillary studies and preliminary diagnosis; the latter can be helpful in rapid clinical decision making. [12][13][14][15] Of particular importance is the presence of an experienced cytopathologist on-site, who can enhance the quality of direct smears by performing proper smearing technique ( Fig.…”

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confidence: 99%

Diagnostic value and cost‐effectiveness of on‐site evaluation of fine‐needle aspiration specimens: Review of 5,688 cases

Nasuti

Gupta

Baloch

2002

Diagnostic Cytopathology

334

292

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Fine-needle aspiration (FNA) has proven to be a safe, economical, accurate, and rapid diagnostic technique. A successful FNA requires a specimen with adequate cellularity, high-quality preparation, an experienced aspirator, and cytopathologist. Up to 32% of FNAs in various organs (thyroid, breast, lung, etc.) may be nondiagnostic due to scant cellularity and poor preparation. On-site immediate evaluation of FNA specimens can be beneficial in determination of adequacy: triage for ancillary studies and provide a preliminary diagnosis of the specimen, which often facilitates rapid clinical decisions. In this study, we compared the on-site FNA interpretation with the final diagnosis and calculated its cost benefit. Reports of 5,688 on-site FNA cases from the files of the University of Pennsylvania Medical Center over a 5-yr period (1/1/96-12/31/00) were reviewed. Data of the immediate on-site interpretation and the final diagnosis in each case were compared to determine the diagnostic accuracy, clinical utility, and cost-effectiveness of on-site FNA evaluation. At our institution the average cost per FNA based on laboratory technical and professional fees (1,743 dollars) and the weighted average cost, based on utilization, of ancillary laboratory studies (328 dollars) and guidance procedures (1,025 dollars) is 3,096 dollars. An additional fee of 231 dollars per case is charged for on-site FNA evaluation by an attending cytopathologist. The average reported rate of nondiagnostic FNAs without on-site evaluation is 20%. Our own nondiagnostic rate for FNAs with on-site evaluation is 0.98%. If one assumes that patients will undergo a repeat FNA for each nondiagnostic specimen, the estimated additional cost in direct institutional charges is 2,022,626 dollars over 5 yr or 404,525 dollars per yr without on-site evaluation. This potential cost savings would be realized by utilizing on-site evaluation despite the additional fee due to a higher rate of specimen adequacy. Based on this study, on-site cytopathologic evaluation of FNA specimens is accurate, cost-effective, and has improved patient care at our institution.

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Problems in Fine-Needle Aspiration Biopsy Cytology of Clinically or Mammographically Uncertain Breast Tumors

Cited by 29 publications

References 20 publications

Fine Needle Aspiration Biopsy of Breast Lesions and Histopathologic Correlation

Fine Needle Aspiration Biopsy of Breast Lesions and Histopathologic Correlation

The role of fine needle aspiration in the diagnosis of thyroid nodules: Analysis of 795 consecutive cases

Diagnostic value and cost‐effectiveness of on‐site evaluation of fine‐needle aspiration specimens: Review of 5,688 cases

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