Ultrasound‐guided fine‐needle aspiration biopsy remains a valid approach in the evaluation of nonpalpable breast lesions

Liao, Jim; Davey, Diane D.; Warren, Graham; Davis, Jefferson; Moore, Angela; Samayoa, Luis

doi:10.1002/dc.20068

Cited by 28 publications

(12 citation statements)

References 24 publications

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“…FNA biopsy, however, cannot distinguish in situ disease from invasive carcinoma or may not be able to adequately sample sclerotic processes, such as radial scars or lobular carcinoma [33, 36]. Lobular carcinoma is rare in men, representing about 1% of male breast lesions [37].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Fine-Needle Aspiration in Male Breast Lesions

et al. 2019

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Objective: Differentiation between gynecomastia, a common cause of male breast enlargement, and breast cancer is crucial for appropriate management. Fine-needle aspiration biopsy has been shown to be sensitive and specific in assessing female breast lesions, comparable to core needle biopsy. Few such studies have been conducted in men. We assessed its diagnostic value in a male patient cohort. Study Design: Men who underwent fine-needle aspiration (FNA) for palpable breast lesions at Massachusetts General Hospital from January 2007 to December 2016 were evaluated. Clinical data, radiographic findings, and cytologic diagnoses of 74 breast FNA from 71 men were reviewed. Breast aspirates were classified as nondiagnostic, benign, atypical, suspicious for malignancy, or malignant. Histology was obtained in 37 cases, and clinical and radiological data were used as follow-up in 37 patients. Results: Most FNA biopsies (73%) were performed by cytopathologists, and 93.2% of the breast FNA in men were adequate; 58% showed benign processes, mostly gynecomastia (n = 22), and 28.4% (n = 21) were malignant, most often ductal carcinoma. No false-positive cytologies were obtained, and there was 1 false-negative cytology. In our study, FNA of palpable male breast lesions was 95.8% sensitive and 100% specific. Conclusions: FNA allows sensitive, specific, and safe evaluation and diagnosis of palpable male breast lesions.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Fine-Needle Aspiration in Male Breast Lesions

et al. 2019

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“…Furthermore it is advisable that patients with deep, centrally located and small or nonpalpable lesions have their FNAC under ultrasound-guidance. This is a safe and highly accurate procedure [14,15]. Pneumothorax after breast FNAC is seen more frequently in patients who have thin bodies and small sized breasts [3].…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax after a clinical breast fine-needle aspiration of a lump in a patient with Poland's syndrome

Salhab

Sarakbi

Perry

et al. 2005

Int Semin Surg Oncol

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We report the first case in the medical literature of a pneumothorax complicating fine needle aspiration cytology (FNAC) of a breast lump in a woman with a mild form of Poland's syndrome. The pneumothorax was treated conservatively. This is the first case of breast FNA-related pneumothorax seen in our clinical practice. We believe that the absence of pectoral muscles has increased the risk of this complication. We have also diagnosed an incidental screen-detected breast cancer affecting the ipsilateral breast in the same patient. We conclude that caution should be exercised when performing FNAC of breast lesions in patients with Poland's syndrome. The procedure should be preferably performed under image guidance in such patients in order to minimise the risk of this complication.

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“…22 This is true when atypia is discovered on UG-FNA of nonpalpable breast lesions. 23 UG-CNB is an appropriate test in these cases and is less invasive and expensive than open biopsy.…”

Section: Value Of Cytopathologist-performed Ultrasound-guided Fnamentioning

confidence: 99%

Value of cytopathologist‐performed ultrasound‐guided fine‐needle aspiration as a screening test for ultrasound‐guided core‐needle biopsy in nonpalpable breast masses

Lieu

2009

Diagnostic Cytopathology

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Fine-needle aspiration (FNA) of breast masses in the United States has been on the decline for the last decade and has been largely replaced by ultrasound-guided core-needle biopsy (UG-CNB). Some studies show core-needle biopsy (CNB) is superior to FNA in terms of absolute sensitivity, specificity, and inadequate rate. However, the importance of a skilled aspirator, experienced cytopathologist, and immediate cytological evaluation (ICE) in FNA is often not considered. CNB is more expensive, invasive, risky, and painful than FNA. This prospective study examines the value of cytopathologist-performed ultrasound-guided FNA (UG-FNA) with ICE as a screening test for cytopathologist-performed UG-CNB on nonpalpable or difficult-to-palpate solid breast masses visible on ultrasound. One hundred twenty consecutive nonpalpable or difficult-to-palpate presumably solid breast masses in 109 female patients from January2, 2008 to June 30, 2008 underwent cytopathologist-performed UG-FNA with ICE. Twenty cases were converted to cytopathologist-performed UG-CNB because ICE was inadequate, hypocellular, atypical, suspicious, or malignant. Patients with clearly benign cytology did not undergo UG-CNB. UG-FNA with ICE reduced the percentage of patients undergoing UG-CNB by 87%. A new role for cytopathologist-performed UG-FNA of nonpalpable breast masses has been identified.

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Ultrasound‐guided fine‐needle aspiration biopsy remains a valid approach in the evaluation of nonpalpable breast lesions

Cited by 28 publications

References 24 publications

Diagnostic Value of Fine-Needle Aspiration in Male Breast Lesions

Diagnostic Value of Fine-Needle Aspiration in Male Breast Lesions

Pneumothorax after a clinical breast fine-needle aspiration of a lump in a patient with Poland's syndrome

Value of cytopathologist‐performed ultrasound‐guided fine‐needle aspiration as a screening test for ultrasound‐guided core‐needle biopsy in nonpalpable breast masses

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