Approach to fine-needle aspiration cytology-negative cases of breast cancer.
OBJECTIVE
To clarify the clinical usefulness of fine-needle aspiration (FNA) cytology of breast tumours and the management of FNA cytology-negative cases suspected of or equivocal for malignancy.


METHODS
FNA cytology was performed in 94 patients between 1995 and 2002. We calculated the sensitivity, specificity and accuracy of FNA cytology for the diagnosis of malignancy. We also compared clinical and radiological findings between false-negative and true-negative cases.


RESULTS
The sensitivity of FNA was 91% (72/79), specificity was 93% (14/15), accuracy was 91% (86/94), positive predictive value was 99% (72/73) and negative predictive value was 67% (14/21). There were seven false-negative cases and one false-positive case. Findings that aroused suspicion of malignancy were more frequent in the false-negative cases, especially from mammography and magnetic resonance imaging (MRI).


CONCLUSIONS
FNA cytology was an accurate preoperative diagnostic procedure for the evaluation of breast masses. In FNA cytology-negative cases, repeated FNA, core needle biopsy or excisional biopsy needs to be performed based on MRI findings.
Mizuno
Shugo
S
First Department of Surgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan. mizuamido@mtj.biglobe.ne.jp
Isaji
Shuji
S
Ogawa
Tomoko
T
Tabata
Masami
M
Yamagiwa
Kentaro
K
Yokoi
Hajime
H
Uemoto
Shinji
S
D000465:Algorithms; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity