Background: The early diagnosis of nonpalpable breast lesions is a medical challenge because of the low specificity of different radiologic modalities. Fine-needle aspiration cytology (FNAC) assisted by a stereotactic guidance is an adjunctive diagnostic approach in the management of these lesions. The primary purpose of this article was to assess the diagnostic accuracy of FNAC in patients with nonpalpable breast lesions.
Methods: Three hundred and seventy-one lesions from 357 patients (all female) underwent FNAC using the stereotactically guided technique. Of these cases, 243 lesions from 238 patients subsequently were acquired by surgical excisional biopsies and formed the basis of this study. Statistical analyses of the cytologic and the histologic diagnoses of these cases were performed.
Results: Histologically, 107 lesions (44%) were benign and 136 lesions (56%) were malignant. Of the 136 malignant lesions, cytology was concordant in 73 lesions (53.7%), suspicious in 15 lesions (11.0%), false-negative in 12 lesions (8.8%) (benign), and unsatisfactory in 36 lesions (26.5%). Among the 107 benign lesions, cytology was concordant with histology in 75 lesions (70.1%), whereas 4 lesions (3.7%) and 28 lesions (26.2%) were cytologically suspicious and unsatisfactory, respectively. No false-positive cytologies were found in the current series.
Conclusions: The current prospective study indicates that mammography combined with FNAC provides an accurate and practical diagnostic approach for the majority of nonpalpable lesions. Patients with unsatisfactory and false-negative lesions should undergo excisional biopsy.