Tags

Type your tag names separated by a space and hit enter

Ultrasound-guided fine needle aspiration cytology of impalpable breast lesions in a rural setting. Comparison of cytology with imaging and final outcome.
Acta Cytol. 1999 Mar-Apr; 43(2):163-8.AC

Abstract

OBJECTIVE

To analyze the effectiveness of fine needle aspiration (FNA) cytology in a multidisciplinary setting in rural Australia and to compare the imaging (mammographic and ultrasound) appearances and cytomorphologic findings with the final outcome.

STUDY DESIGN

Prospective analysis of ultrasound-guided FNA cytology results from 426 women, aged 40-86 years, with screening-detected mammographic abnormalities. Cases of microcalcification, assessed mainly by stereotactatic core biopsy, were not included in the study. The FNAs were performed at a rural breast screening and assessment program in New South Wales, Australia, over a three-year period between May 1993 and May 1996.

RESULTS

Imaging, FNA and combined imaging and FNA results from 426 women were as follows. The imaging diagnoses included 176 (41%) benign, 34 (8%) probably benign, 17 (4%) equivocal, 104 (24%) suspicious and 95 (23%) malignant cases. The FNA findings showed 59 (14%) no epithelial cells seen (nondiagnostic), 175 (41%) benign, 36 (8%) atypical, 41 (10%) suspicious and 115 (27%) malignant. Combined imaging and cytologic results comprised 224 (52.6%) benign, 10 (2.3%) atypical/equivocal, 59 (13.9%) suspicious and 133 (31.2%) malignant cases. All the malignant cases, by combined assessment, had malignant histology, and all the benign cases behaved in a benign fashion. In 80% of the suspicious lesions, the histologic diagnosis was malignant, but only 10% of the atypical/equivocal lesions had malignant histology. The positive predictive value of diagnosis of malignancy by combined imaging and FNA was 100%, and the false negative rate was 0%.

CONCLUSION

Despite the recent surge in the popularity of core biopsy, FNA cytology of impalpable, mammographically detected lesions, when practiced in a multidisciplinary setting, is an extremely accurate test with high sensitivity, specificity, predictive values and efficacy. FNA cytology of the breast is a well-tolerated, relatively noninvasive test with a very low risk of complications. The sensitivity and positive predictive values for malignant and suspicious mammographic categories are also very high.

Authors+Show Affiliations

Canberra Hospital, Garran, ACT, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10097704

Citation

Zardawi, I M., et al. "Ultrasound-guided Fine Needle Aspiration Cytology of Impalpable Breast Lesions in a Rural Setting. Comparison of Cytology With Imaging and Final Outcome." Acta Cytologica, vol. 43, no. 2, 1999, pp. 163-8.
Zardawi IM, Hearnden F, Meyer P, et al. Ultrasound-guided fine needle aspiration cytology of impalpable breast lesions in a rural setting. Comparison of cytology with imaging and final outcome. Acta Cytol. 1999;43(2):163-8.
Zardawi, I. M., Hearnden, F., Meyer, P., & Trevan, B. (1999). Ultrasound-guided fine needle aspiration cytology of impalpable breast lesions in a rural setting. Comparison of cytology with imaging and final outcome. Acta Cytologica, 43(2), 163-8.
Zardawi IM, et al. Ultrasound-guided Fine Needle Aspiration Cytology of Impalpable Breast Lesions in a Rural Setting. Comparison of Cytology With Imaging and Final Outcome. Acta Cytol. 1999 Mar-Apr;43(2):163-8. PubMed PMID: 10097704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasound-guided fine needle aspiration cytology of impalpable breast lesions in a rural setting. Comparison of cytology with imaging and final outcome. AU - Zardawi,I M, AU - Hearnden,F, AU - Meyer,P, AU - Trevan,B, PY - 1999/3/31/pubmed PY - 1999/3/31/medline PY - 1999/3/31/entrez SP - 163 EP - 8 JF - Acta cytologica JO - Acta Cytol VL - 43 IS - 2 N2 - OBJECTIVE: To analyze the effectiveness of fine needle aspiration (FNA) cytology in a multidisciplinary setting in rural Australia and to compare the imaging (mammographic and ultrasound) appearances and cytomorphologic findings with the final outcome. STUDY DESIGN: Prospective analysis of ultrasound-guided FNA cytology results from 426 women, aged 40-86 years, with screening-detected mammographic abnormalities. Cases of microcalcification, assessed mainly by stereotactatic core biopsy, were not included in the study. The FNAs were performed at a rural breast screening and assessment program in New South Wales, Australia, over a three-year period between May 1993 and May 1996. RESULTS: Imaging, FNA and combined imaging and FNA results from 426 women were as follows. The imaging diagnoses included 176 (41%) benign, 34 (8%) probably benign, 17 (4%) equivocal, 104 (24%) suspicious and 95 (23%) malignant cases. The FNA findings showed 59 (14%) no epithelial cells seen (nondiagnostic), 175 (41%) benign, 36 (8%) atypical, 41 (10%) suspicious and 115 (27%) malignant. Combined imaging and cytologic results comprised 224 (52.6%) benign, 10 (2.3%) atypical/equivocal, 59 (13.9%) suspicious and 133 (31.2%) malignant cases. All the malignant cases, by combined assessment, had malignant histology, and all the benign cases behaved in a benign fashion. In 80% of the suspicious lesions, the histologic diagnosis was malignant, but only 10% of the atypical/equivocal lesions had malignant histology. The positive predictive value of diagnosis of malignancy by combined imaging and FNA was 100%, and the false negative rate was 0%. CONCLUSION: Despite the recent surge in the popularity of core biopsy, FNA cytology of impalpable, mammographically detected lesions, when practiced in a multidisciplinary setting, is an extremely accurate test with high sensitivity, specificity, predictive values and efficacy. FNA cytology of the breast is a well-tolerated, relatively noninvasive test with a very low risk of complications. The sensitivity and positive predictive values for malignant and suspicious mammographic categories are also very high. SN - 0001-5547 UR - https://www.unboundmedicine.com/medline/citation/10097704/Ultrasound_guided_fine_needle_aspiration_cytology_of_impalpable_breast_lesions_in_a_rural_setting__Comparison_of_cytology_with_imaging_and_final_outcome_ L2 - https://www.karger.com?DOI=10.1159/000330971 DB - PRIME DP - Unbound Medicine ER -