The results of 49 specimens obtained by fine-needle aspiration biopsy of parotid gland lesions were compared with the pathologic diagnoses of the surgically resected specimens. Cytologically, 33 lesions were diagnosed as benign, with 30 of these confirmed histologically and three false-negative results. Fourteen cytologic specimens were called malignant or suspicious for malignancy, with 11 of these confirmed histologically and three false-positive results. The concurrence rate for distinguishing benign from malignant disease was 87.2%. The sensitivity for malignancy was 78.6% and the specificity 90.9%. The pathology of the misdiagnosed lesions will be reviewed. Based on our data and a review of the literature, we conclude that fine needle aspiration biopsy of parotid gland masses, with the observation of certain caveats, is a helpful adjunctive test for diagnosis and treatment planning.
Fine-needle aspiration cytology and Tru-cut needle biopsy have been described as excellent techniques in the diagnosis of breast cancer. Responses to questionnaires sent to 90 pathologists in San Diego County, however, proved that in only 2-10% of all new breast cancer cases are these techniques being used to make the initial diagnosis. This paradox appeared to be due mainly to a reluctance of clinicians to use these techniques. However, there also appeared to be a lack of confidence and training among pathologists in interpreting aspiration cytology specimens. In the authors' and other pathologists' opinion, reviewing breast aspiration cytology specimens requires special training and regular exposure to such material, whereas Tru-cut needle biopsy specimens can be interpreted accurately by almost any pathologist without special training. The results of our own series of needle biopsies and aspiration cytology in the diagnosis of breast cancer are presented and compared to those reported in several other published reports. These data indicate that approximately 90% (89% in our series) of all palpable breast cancers can be diagnosed by needle biopsy techniques.
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