[Fine-needle aspiration cytology or core biopsy when diagnosing tumours of the breast]. / Cytologisk finnålsaspirasjon eller grovnålsbiopsi ved diagnostikk av tumor mammae?

ABSTRACT

BACKGROUND: Fine-needle aspiration (FNA) biopsy is an established, highly accurate method for diagnosing breast lesions. In recent years, core biopsy (CB) has been increasingly used. The aim of this study was to compare the quality assessment parameters of FNA and CB in palpable and non-palpable breast lesions. METHODS: Data on FNA and CB results were retrieved from the pathology database and 4367 FNA samples and corresponding histology results from 1275 lesions were compared. Quality assessment parameters were calculated using the methodology detailed in the National Health Service breast screening programme guidelines. RESULTS: High absolute and complete specificity, absolute and complete sensitivity and low inadequate rates were found for CB compared with FNA. Low specificity for FNA was particularly seen in collagenous lesions and in submitted specimens sampled by doctors without particular experience with the FNA procedure. INTERPRETATION: CB may be an alternative method for preoperative diagnosis when experienced cytopathologists are not available. CB is superior to FNA in fibrotic and collagenous lesions such as lobular carcinoma and radial scar due to low cellularity. FNA is the more accurate method when an immediate assessment by a cytopathologist is performed for evaluation of adequate material so that additional aspirations can be done if needed.