title: Value of sonographically guided needle sampling of cystic versus solid components in the diagnosis of complex cystic breast masses.
abstract: BACKGROUND
  The common practice for diagnosis of complex cystic breast masses (CCBM) may be imaging-guided aspiration or biopsy of cystic or solid components.
  
  
  OBJECTIVE
  To assess the diagnostic value of sonographically guided needle sampling of cystic and solid components for CCBM.
  
  
  METHODS
  Twenty patients with 20 CCBM underwent sonographically guided fine-needle aspiration biopsy (FNAB) for cystic components, followed by core needle biopsy (CNB) for residual solid components. The diagnostic results of each were evaluated. Excisional biopsy or mastectomy served as a reference standard.
  
  
  RESULTS
  Fourteen (70%) masses were malignant. Needle sampling for cystic components of the 14 malignant tumors showed malignancy in one (7%), atypia in four (29%), benign findings in four (29%), and insufficient samples in five (36%). Needle sampling for residual solid components showed malignancy in 11 (79%), atypia in two (14%), and insufficient sample in one (7%). The diagnostic yield of needle sampling of solid components was significantly higher than that of cystic components for malignant CCBM (P<0.05). Sixteen (80%) of 20 CCBMs showed bloody fine-needle aspirates. There was no significant difference between the rates of bloody aspirates of malignant and benign CCBM (86% vs. 67%, P=0.55).
  
  
  CONCLUSIONS
  Sonographically guided needle sampling of solid components may help to identify most malignant CCBMs, and the aspirated fluid may be discarded due to low diagnostic value.
authors.affiliation: Departments of Radiology,Tri-Service General Hospital and National Defense MedicalCenter, No. 325 Sec. 2 Cheng-Kung Road, Taipei, Taiwan.
authors.forename: Wen-Chiung
authors.initials: WC
authors.lastname: Lin
authors.forename: Giu-Cheng
authors.initials: GC
authors.lastname: Hsu
authors.forename: Cheng-Ping
authors.initials: CP
authors.lastname: Yu
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Hsiu-Nan
authors.initials: HN
authors.lastname: Lee
authors.forename: Hsian-He
authors.initials: HH
authors.lastname: Hsu
authors.forename: Tsun-Hou
authors.initials: TH
authors.lastname: Chang
authors.forename: Tom
authors.initials: T
authors.lastname: Chen
authors.forename: Chao-Shiang
authors.initials: CS
authors.lastname: Li
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005348:Fibrocystic Breast Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D014463:Ultrasonography