Value of sonographically guided needle sampling of cystic versus solid components in the diagnosis of complex cystic breast masses.
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.
Lin
Wen-Chiung
WC
Departments of Radiology,Tri-Service General Hospital and National Defense MedicalCenter, No. 325 Sec. 2 Cheng-Kung Road, Taipei, Taiwan.
Hsu
Giu-Cheng
GC
Yu
Cheng-Ping
CP
Yu
Jyh-Cherng
JC
Lee
Hsiu-Nan
HN
Hsu
Hsian-He
HH
Chang
Tsun-Hou
TH
Chen
Tom
T
Li
Chao-Shiang
CS
Huang
Guo-Shu
GS
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