title: Management of palpable but radiologically occult breast abnormalities.
abstract: OBJECTIVE
  To examine the utility of palpation-guided fine-needle aspiration cytology (pgFNAC) in the context of clinically palpable but radiologically occult breast abnormalities in this era of digital mammography and high sensitivity ultrasound.
  
  
  METHODS
  Women undergoing pgFNAC from January 2005 to December 2007 were identified from the histopathology database and correlated with clinical and radiological findings recorded prospectively in electronic patient records.
  
  
  RESULTS
  142 cases matching our selection criteria were identified with a mean age of 43 (SD ±13.7) years; 83 patients had focal lumps and 59 had non-focal lumpiness. In the latter, pgFNAC showed C1 cytology in 45 (76.3%), C2 in 13 (22%) and C3 in 1 (1.7%) patient. In 83 patients with a focal discrete lump, pgFNAC revealed C1 cytology in 65 (78.3%), C2 in 14 (16.9%), and 2 patients each had C3 and C4 cytology. Core biopsy was undertaken in the latter 4 patients, invasive cancer was found in 1 patient each with C3 and C4 cytology and benign pathology in the rest. To date, none of the patients discharged has developed pre-malignant or malignant lesions in the ipsilateral breast.
  
  
  CONCLUSIONS
  In patients presenting with clinically palpable but radiologically occult breast abnormality, pgFNAC can identify those who need further investigation or who can be safely discharged.
authors.affiliation: Department of Breast Surgery, Leeds Teaching Hospitals National Health Service Trust, Leeds, UK. drsreek_79@yahoo.co.in
authors.forename: Sreekumar
authors.initials: S
authors.lastname: Sundara Rajan
authors.forename: Jonathan
authors.initials: J
authors.lastname: White
authors.forename: Adam
authors.initials: A
authors.lastname: Peckham-Cooper
authors.forename: Sally
authors.initials: S
authors.lastname: Lane
authors.forename: Mark
authors.initials: M
authors.lastname: Lansdown
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D010173:Palpation; D011446:Prospective Studies; D012189:Retrospective Studies