A ONE-YEAR AUDIT OF FINE-NEEDLE ASPIRATION CYTOLOGY OF BREAST-LESIONS- FACTORS AFFECTING ADEQUACY AND A REVIEW OF DELAYED CARCINOMA DIAGNOSES

OBJECTIVE: To compare the rate of inadequate specimens in a triple-dia gnosis breast clinic with that of specimens taken by clinicians. STUDY DESIGN: Breast aspirates obtained in 1993, 2,923 specimens, were revi ewed. Of these, 1,515 (51.9%) were taken in a specialist clinic with a triple approach (clinical examination, imaging and aspiration cytolog y). Palpable lesions weve aspirated by a cytopathologist and nonpalpab le lesions by a cytopathologist and radiologist in cooperation using i maging techniques. The rate of inadequate specimens was determined and compared with the rate of the remaining specimens, which were sent to the laboratory by clinicians. RESULTS: In the breast clinic, the inad equacy rate was 3.8% (n = 58). The inadequacy rate for the 1,408 maile d breast aspirates was 14.8% (n = 209). A cancer diagnosis was recorde d in 13.5% (n = 395). Six carcinomas were diagnosed late because of in adequate specimens. CONCLUSION: The inadequacy rate was lower in cytol ogy samples taken in a specialized breast clinic than in samples maile d to the laboratory by clinicians. In order to increase the detection rate of malignancies, clinicians performing fine needle aspiration sho uld be trained in the aspiration technique and smear preparation.