Effectiveness of fine‐needle aspiration cytology of breast: Analysis of 2,375 cases from northern Thailand

Abstract

At the Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand, 2,375 cases of breast lesions were sampled by fine-needle aspiration (FNA) from 1994-1999. Cytologic diagnoses were: benign (48%), suspicious for malignancy (5%), malignant (15%), and unsatisfactory (32%). Comparison with histology was possible in 721 cases. The diagnoses obtained by FNA showed a sensitivity of 84.4%, specificity of 99.5%, positive predictive value of 99.8%, negative predictive value of 84.3%, false-negative rate of 16.7%, false-positive rate of 0.5%, and overall diagnostic accuracy of 91.3%. We conclude that, in experienced hands, FNA of breast masses is reliable for diagnosis. Assessment of samples at the time of aspiration can reduce the number of inadequate specimens to near zero. Correlation of FNA results with clinical and radiologic findings can identify false-negatives and false-positives, ensuring optimal patient management. Many centers now recommend needle core biopsy instead of FNA. For regions such as ours, the added cost of this test would make it unavailable to many patients, which could delay a diagnosis of breast cancer. We advocate keeping FNA as a first-line diagnostic procedure, at least in areas under economic restrictions, in order to maximize the availability of health care to women with breast disease.

Diagnostic Value of Fine Needle Aspiration Cytology for Breast Tumors

“…Th ese fi ndings are in line with previous reports 15 . According to various studies, the false-positive rate ranges from 0 to 2.5%, which is slightly lower than 3.2% found in this study 4,5,15 . Th e false-negative rate in our study was 1.6%, which is lower in comparison to other .…”

Diagnosis of breast cancer using diffuse optical spectroscopy from 500 to 1600 nm: comparison of classification methods

“…Moreover, indeterminate pathology analysis will result in the need of repeat biopsies in between 4% to 32% of patients. [1][2][3][4][5][6] Breast conservative therapy, aimed at conserving as much breast tissue as possible, is the treatment of choice in patients with T1-T2 breast tumors. However, the rate of irradical resection and the need for a secondary surgical procedure is often over 10%, depending on the specific definition.…”

The Accuracy of Fine Needle Aspiration on Superficial Palpable Body Masses in Patients at Tikrit City

“…The other case of in situ ductal carcinoma (comedocarcinoma) misdiagnosed as juvenile atypical fibroadenoma in 23 years old female & because of the patient age is an important consideration in diagnosing breast tumors as stated by Rogers [20], and to be more conservative in the diagnosis of breast cancer in young female without delay in histopathological confirmation, with caution against definitive benign diagnosis if the cells are hyperchromatic and many of them lack small regular nucleoli with paucity of single bipolar nuclei in the background. The third false negative breast mass which diagnosed as lipoma and histologically proved to be poorly differentiated invasive ductal carcinoma (schirrous type), factors contributing to false negative results may include: small tumor size, hypocellularity and inadequate sampling of a particular histologic type as low grade carcinoma or schirrous carcinoma (fibrotic lesion) [15,21,22] with special recommendation of core biopsy here to yield more diagnostic material than FNA when dealing with fibrotic lesions [13]. The best way to minimize these missed malignancies is the use of team work for a "triple diagnosis" which is a combination of physical examination, mammography and FNA that has been shown to be highly sensitive and specific in the diagnosis of breast cancer [9,[23][24][25].…”