Eleven years of experience reveals that fine-needle aspiration cytology is still a useful method for preoperative diagnosis of breast carcinoma

Fine needle aspiration cytology (FNAC) has been used extensively for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy such as core biopsy has been used and the clinical value of FNAC has therefore been questioned. To answer this clinical question, we performed an 11-year study in which 1238 aspirates from patients with a breast lump were involved. In total, 1071 breast carcinomas were diagnosed with postoperative histological diagnosis. One thousand and forty-six of these 1071 breast carcinomas were definitely diagnosed by FNAC. Only one breast carcinoma identified by FNAC was not finally verified by histological diagnosis postoperatively. The diagnostic sensitivity, diagnostic specificity, overall accuracy, and the pseudo-negative and pseudo-positive results of FNAC for diagnosing breast carcinoma are 97.72%, 99.4%, 97.94%, 2.28%, and 0.6%, respectively. The method is rapid, accurate, and essentially complication-free, particularly in patients for neoadjuvant chemotherapy or endocrine therapy. The results suggest that FNAC is still a useful and reliable method for the preoperative diagnosis of breast carcinoma. (c) 2007 Elsevier Ltd. All rights reserved.