Role of fine-needle aspiration cytology in nonpalpable mammary lesions: A comparative cytohistologic study based on 308 cases

This study evaluated the results of fine needle aspiration cytology (FNAC) from the first four years of organized mammography screening for breast cancer in Oslo, particularly our policy in differentiating in situ and invasive carcinoma. Lesions were aspirated directly, ultrasound guided, by stereotaxic device or biopsy localization plate. All lesions were aspirated by cytopathologists working with the radiologists at the breast diagnostic centre. Smears were evaluated immediately for assessment of adequacy and a preliminary diagnosis was given to the surgeon. When FNAC revealed malignancy, diagnostic terms were as follows: (1) invasive carcinoma; (2) ductal carcinoma in situ of comedo type (high nuclear grade), cannot evaluate infiltration; (3) ductal carcinoma in situ of low nuclear grade and (4) papillary tumour, cannot evaluate infiltration. There were 953 cases, 70% of which were nonpalpable. Insufficient material was obtained in 5.8%. Absolute and complete sensitivity were 81% and 91%, respectively. Specificity was 85%. There were 448 histologically proven carcinomas. 383 of these were invasive. 362 carcinomas (in situ and invasive) (80.8%) were diagnosed directly on FNAC. Distinction between invasive and in situ carcinoma was possible in 294 of 320 directly diagnosed invasive carcinomas (91.8%). PPV of a diagnosis of invasive carcinoma was 97%. Our data showed that definitive cytological diagnosis of invasive carcinoma was possible in more than 90% of fully diagnostic smears and allowed definitive primary surgery in these women.

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“…70% of the lesions were nonpalpable and our results were similar to what has been reported from other centres 2 , 22–28 …”

Section: Discussionsupporting

confidence: 91%

Fine needle aspiration cytology in the work‐up of mammographic and ultrasonographic findings in breast cancer screening: an attempt at differentiating in situ and invasive carcinoma

2002

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“…33 Its role is also questionable in lobular carcinoma, granular cell lesions, and spindle-cell neoplasm. 25,[34][35][36][37] The results of FNAC are variable from center to center and country to country; however, the overall accuracy is consistent everywhere in the world (Table IX).…”

Section: Discussionmentioning

confidence: 88%

Comparison of accuracy of diagnostic modalities for evaluation of breast cancer with review of literature

Bukhari

Akhtar

2009

Diagnostic Cytopathology

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This study was conducted to confirm which of these modalities [mammography (MG), fine-needle aspiration cytology (FNAC), core-needle biopsy (CNB), or intraoperative touch imprint cytology (IOTIC)] is useful to detect breast cancer and to compare the accuracy of these modalities for the diagnostic setting. One hundred seventy-five, 85, 78, and 25 patients were selected who underwent FNAC, MG, IOTIC, and CNB, respectively. Histopathology was used as a gold standard for comparison of the results of all diagnostic modalities. Twenty-five patients with combinations of three preoperative tests (MG, FNAC, CNB) showed 100% accurate results when compared with histopathology, while the overall accuracy for MG, FNAC, and CNB was 91.7%, 91.5%, and 96%, respectively. Both touch and scrape imprints' sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy were 100% for class V and class II smears, while sensitivity, accuracy, and NPV were 87, 95, and 83% for IOTIC and 94%, 96%, and 89% for IOSC for class III and IV smears. On comparison of the results of all these procedures, the difference was nonspecific (P = 0.2, 0.3, 0.5, 0.55, and 0.6 for MG, FNAC, IOTI, IOSC, and CNB, respectively). Combinations of preoperative tests (MG, FNAC, CNB) were more accurate, reliable, and acceptable when compared with individual diagnostic procedure, but these have their own technical limitations. The accuracy of CNB was much higher than that of MG and FNAC. IOTP and IOSC are simple and cost effective diagnostic tests with better accuracy that can be used as an alternate to frozen section in diagnostic settings and margin assessments.

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“…Z anconati and associates also confirm that FNAC in non‐palpable breast tumors is less accurate in ILC, tubular carcinomas and in DCIS of non‐comedo type than in other kinds of breast malignancies. They also reported that preoperative atypical or suspicious cytology in combination with benign postoperative histopathology is more frequent when there has been a sampling mistake or technically inadequate smears (21).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Stereotactic Fine Needle Aspiration Cytology and Core Needle Biopsy in 522 Non-Palpable Breast Lesions

Leifland¹,

Lagerstedt

Svane

2003

Acta Radiologica

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Role of fine-needle aspiration cytology in nonpalpable mammary lesions: A comparative cytohistologic study based on 308 cases

Cited by 15 publications

References 22 publications

Fine needle aspiration cytology in the work‐up of mammographic and ultrasonographic findings in breast cancer screening: an attempt at differentiating in situ and invasive carcinoma

Fine needle aspiration cytology in the work‐up of mammographic and ultrasonographic findings in breast cancer screening: an attempt at differentiating in situ and invasive carcinoma

Comparison of accuracy of diagnostic modalities for evaluation of breast cancer with review of literature

Comparison of Stereotactic Fine Needle Aspiration Cytology and Core Needle Biopsy in 522 Non-Palpable Breast Lesions

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