Mammographically detected breast lesions: clinical importance of cytologic atypia in stereotaxic fine-needle aspiration biopsy samples.
OBJECTIVE
To correlate cytologic findings of stereotaxic fine-needle aspiration biopsy samples with histologic findings of excised samples of nonpalpable mammographically detected lesions.


METHODS
In a retrospective review of 2,988 consecutive stereotaxic fine-needle aspiration biopsy samples of nonpalpable breast lesions obtained within 5 years, 70 samples were categorized as atypical. Excision with needle localization and specimen radiography were performed in all lesions; cytologic findings of aspirates were correlated with histologic findings of excised samples. Histologic findings were the standard of reference.


RESULTS
Of the 70 atypical aspirates, 27 were benign (38%) and 43 were malignant (61%). Both the benign and the malignant lesions had an average size at mammography of 1.1 cm. The nuclear grade was low in 21 (49%), moderate in 16 (37%), and high in six (14%) of the malignant lesions. There were axillary lymph node metastases in four samples (9%).


CONCLUSIONS
Although lesions with atypical aspirates usually are benign, to achieve a low prevalence of false-negative diagnoses atypia must be interpreted as potential malignancy.
Mitnick
J S
JS
Murray Hill Radiology and Mammography, New York, NY 10016, USA.
Vazquez
M F
MF
Feiner
H D
HD
Pressman
P
P
Roses
D F
DF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013238:Stereotaxic Techniques