Analysis of fine needle aspiration cytology of the breast: a review of 1,297 cases and correlation with histologic diagnoses.
OBJECTIVE
To evaluate the accuracy of fine needle aspiration (FNA) cytology of the breast and to ascertain its usefulness.


METHODS
The authors reviewed 1,297 cases of FNA cytology of the breast which were performed at Chonnam National University Hospital from 1999 to 2002. Cytologic diagnoses were compared with histologic diagnoses in 457 cases that underwent both cytologic and histologic examination.


RESULTS
Of 1,297 cases, 1,201 (92.6%) were satisfactory and 96 (7.4%) unsatisfactory. Subsequent histologic examination was performed on 291 cases (29.7%) out of 981 "benign" lesions, 28 (73.7%) of 38 "suspicious," 124 (68.1%) of 182 "malignant" and 14 (14.6%) of 96 "unsatisfactory." FNA cytology revealed 77.7% sensitivity, 99.2% specificity, 98.4% positive predictive value and 88.0% negative predictive value. Diagnostic accuracy was 91.1%. Of the 291 benign cases on cytology, 35 cases were malignancy on histology. Of the 124 cases reported as malignant, 2 were benign. Interpretive error was the leading cause of false positive diagnoses.


CONCLUSIONS
Although FNA cytology is a useful diagnostic procedure for the evaluation of breast lesions, it should be combined with other diagnostic modalities, such as physical examination, ultrasonography and mammography.
Choi
Yoo Duk
YD
Department of Pathology, Chonnam National University Research Institute of Medical Sciences, Gwangju, Republic of Korea.
Choi
Young Hyo
YH
Lee
Jae-Hyuk
JH
Nam
Jong Hee
JH
Juhng
Sang-Woo
SW
Choi
Chan
C
D044963:Biopsy, Fine-Needle / Q000592:standards*; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D003951:Diagnostic Errors / Q000517:prevention & control*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013997:Time Factors