MAMMOGRAPHICALLY DETECTED BREAST-LESIONS - CLINICAL IMPORTANCE OF CYTOLOGIC ATYPIA IN STEREOTAXIC FINE-NEEDLE ASPIRATION BIOPSY SAMPLES

PURPOSE: To correlate cytologic findings of stereotaxic fine-needle as piration biopsy samples with histologic findings of excised samples of nonpalpable mammographically detected lesions. MATERIALS AND METHODS: In a retrospective review of 2,988 consecutive stereotaxic fine-needl e aspiration biopsy samples of nonpalpable breast lesions obtained wit hin 5 years, 70 samples were categorized as atypical. Excision with ne edle localization and specimen radiography were performed in all lesio ns; cytologic findings of aspirates were correlated with histologic fi ndings of excised samples. Histologic findings were the standard of re ference. RESULTS: Of the 70 atypical aspirates, 27 were benign (38%) a nd 43 were malignant (61%). Both the benign and the malignant lesions had an average size at mammography of 1.1 cm. The nuclear grade was lo w in 21 (49%), moderate in 16 (37%), and high in six (14%) of the mali gnant lesions. There were axillary lymph node metastases in four sampl es (9%). CONCLUSION: Although lesions with atypical aspirates usually are benign, to achieve a low prevalence of false-negative diagnoses at ypia must be interpreted as potential malignancy.