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

Abstract

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.

Disease-specific gene repositioning in breast cancer

“…In addition, we identified several combinations of two or three multiplexed markers that detect cancerous tissues with no false negative signals and a low rate of false positive outcomes. The false detection rate of this approach compares favorably to the current, standard breast cancer diagnostic tests, such as fine-needle aspiration cytology and core-needle biopsy cytology, for which false positive rates of 0-44% and 0-13.4%, respectively, and false negative rates of 1.3-39% and 4.5-17%, respectively, have been described (Arisio et al, 1998;Young et al, 2002;Chaiwun and Thorner, 2007;Ciatto et al, 2007;Bukhari and Akhtar, 2009); however, these rates, in contrast to our analysis, also include specimen sampling errors. Importantly, however, the broad range in false detection rates in conventional cytological assays is also largely related to the experience of the examining cytopathologist.…”

A decade of breast cancer screening in The Netherlands: trends in the preoperative diagnosis of breast cancer

“…At the start of our study, percutaneous diagnosis of malignancy was solely obtained by means of FNAC. Some authors indicate that FNAC offers a reliable and simple alternative to open biopsy of nonpalpable breast lesions [23][24][25]. On the other hand, a large multicenter trial demonstrated that FNAC of nonpalpable breast abnormalities had limited value given the high insufficient sample rate and greater diagnostic accuracy of other interventions such as core-needle biopsy and needle-localized open surgical biopsy [26,27].…”

Characterisation of breast fine-needle aspiration biopsies by centrosome aberrations and genomic instability

“…Fine-needle aspiration biopsy (FNAB) is a well established, low cost, rapid and minimally invasive technique for diagnosing suspicious breast lesions that can reduce the need of surgical biopsies by preoperative diagnosis (Franzen and Zajicek, 1968;Arisio et al, 1998). The accuracy through which lesions can be targeted has been improved by sonography and mammography guided aspiration techniques.…”