A one-year audit of fine needle aspiration cytology of breast lesions. Factors affecting adequacy and a review of delayed carcinoma diagnoses.
OBJECTIVE
To compare the rate of inadequate specimens in a triple-diagnosis breast clinic with that of specimens taken by clinicians.


METHODS
Breast aspirates obtained in 1993, 2,923 specimens, were reviewed. Of these, 1,515 (51.9%) were taken in a specialist clinic with a triple approach (clinical examination, imaging and aspiration cytology). Palpable lesions were aspirated by a cytopathologist and nonpalpable lesions by a cytopathologist and radiologist in cooperation using imaging techniques. The rate of inadequate specimens was determined and compared with the rate of the remaining specimens, which were sent to the laboratory by clinicians.


RESULTS
In the breast clinic, the inadequacy rate was 3.8% (n = 58). The inadequacy rate for the 1,408 mailed breast aspirates was 14.8% (n = 209). A cancer diagnosis was recorded in 13.5% (n = 395). Six carcinomas were diagnosed late because of inadequate specimens.


CONCLUSIONS
The inadequacy rate was lower in cytology samples taken in a specialized breast clinic than in samples mailed to the laboratory by clinicians. In order to increase the detection rate of malignancies, clinicians performing fine needle aspiration should be trained in the aspiration technique and smear preparation.
D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008327:Mammography