Fine Needle Aspiration Cytology in Symptomatic Breast Lesions: Still an Important Diagnostic Modality?

The objective of this study was to make an assessment of the utility of fine needle aspiration cytology (FNAC), in a 'one-stop' symptomatic breast triple assessment clinic. Controversy surrounds the optimal tissue biopsy methodology in the diagnosis of symptomatic breast cancer and the identificatio...

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Publicado en:Breast Journal Vol. 18; no. 2; pp. 103 - 111
Autores principales: Smith, Myles J., Heffron, Cynthia C., Rothwell, Jane R., Loftus, Barbara M., Jeffers, Michael, Geraghty, James G.
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Mar/Apr2012
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar/Apr2012
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1524-4741.2012.01223.x
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        atl: Fine Needle Aspiration Cytology in Symptomatic Breast Lesions: Still an Important Diagnostic Modality?
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          Smith, Myles J.
          Heffron, Cynthia C.
          Rothwell, Jane R.
          Loftus, Barbara M.
          Jeffers, Michael
          Geraghty, James G.
        affil: Department of Surgery, Adelaide and Meath Incorporating the National Children's Hospital (AMNCH), Tallaght, Dublin, Ireland
      sug:
        subj:
          Breast Neoplasms Diagnosis
          Breast Neoplasms Symptoms
          Biopsy, Needle Evaluation
          Human
          Female
          Descriptive Statistics
          Prospective Studies
          Sensitivity and Specificity
          Predictive Value of Tests
          Adult
          Middle Age
          Neoplasm Staging
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
      ab: The objective of this study was to make an assessment of the utility of fine needle aspiration cytology (FNAC), in a 'one-stop' symptomatic breast triple assessment clinic. Controversy surrounds the optimal tissue biopsy methodology in the diagnosis of symptomatic breast cancer and the identification of benign disease. FNAC in the context of a Rapid Assessment Breast Clinic (RABC) allows the same day diagnosis and early treatment of breast cancer, with the immediate reassurance and discharge of those with benign disease. We analyzed prospective data accrued at a RABC, over a 4-year period from 2004 to 2007. All patients were triple assessed, with FNACs performed on site by two consultant cytopathologists. Investigations were reported immediately, and clinical data were captured via a database using compulsory data field entry. There were 4487 attendances at our RABC, with 1572 FNACs were performed. The positive predictive value of FNAC with a C5 cancer diagnosis was 100%, 95.6% for a C4 report, with a complete sensitivity of 94%. The full specificity of correctly identified benign lesions was 77.4%, with a false negative rate of 3.85%. This enabled 66% of patients attending the RABC to receive a same day diagnosis of benign disease and discharge. FNAC is highly accurate in the diagnosis of symptomatic breast cancer in an RABC. FNAC allows accurate diagnosis of benign disease and immediate discharge of the majority of patients. In this era, when a large majority of patients have benign disease, we believe that FNAC provides an equivalent, if not better, method of evaluation of patients in a triple assessment RABC.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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