Nonpalpable, well-defined, probably benign breast nodule: management by fine-needle aspiration biopsy and long-interval follow-up mammography.
The management of nonpalpable, well-defined breast nodules by short-interval, 6-month follow-up mammography is widely accepted. We have, however, been managing these type of lesions with fine-needle aspiration biopsy (FNAB), guided by sonography or stereotaxic approach, in order to reduce the number of follow-up mammograms. We recommended surgical biopsy only in cases with malignant or suspicious cytology. Patients with benign cytology or inadequate sample were included in a 12-month-interval mammography surveillance program. In the series we present, two carcinomas were diagnosed among 145 lesions (1.38 %). Both had shown malignancy in FNAB. Another two cases, suspicious of malignancy in FNAB, finally resulted benign in histology. The remaining 141 nodules, monitored for at least 2 years, or surgically removed at the patient's request, have not shown signs of malignancy, regardless of a diagnosis of either benign or inadequate sample in FNAB. Sensitivity and negative predictive value of FNAB have therefore been 100 % in this series. No notable differences were observed between stereotaxic and sonographic guidance, except the percentage of inadequate samples (20.3 % by sonography; 25.9 % by stereotaxic sampling). We conclude that stereotaxic or sonographic FNAB is a very accurate diagnostic method in lesions of this type, allowing long-interval surveillance of the nodules with nonsuspicious cytological results.
Apesteguía
L
L
Department of Radiology, Hospital Virgen del Camino, C/Irunlarrea 4, E-31 008 Pamplona, Spain.
Pina
L
L
Inchusta
M
M
Mellado
M
M
Franquet
T
T
De Miguel
C
C
López-Cousillas
A
A
Repáraz
B
B
D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis* / Q000453:epidemiology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis / Q000453:epidemiology; D005348:Fibrocystic Breast Disease / Q000175:diagnosis / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013238:Stereotaxic Techniques; D013997:Time Factors; D016217:Ultrasonography, Mammary