IMPACT OF FINE-NEEDLE ASPIRATION CYTOLOGY, ULTRASONOGRAPHY AND MAMMOGRAPHY ON OPEN BIOPSY RATE IN PATIENTS WITH BENIGN BREAST DISEASE

The management of breast disease has been influenced by breast imaging and fine-needle aspiration cytology (FNAC) for preoperative diagnosis . To investigate the impact of introducing an in-clinic FNAC service o n patient management, the pathology records of patients presenting bef ore and after introduction of the service were studied. Four managemen t changes emerged. The number of patients investigated by histology an d/or cytology increased (from 266 to 503), as did specimen numbers (39 2 to 728). The use of pathological services changed, with more cytolog y specimens (39 to 554), fewer needle-core biopsies (62 to three) and ewer excision biopsies (245 to 118). The number of patients admitted f or surgery fell, especially those with a benign histological diagnosis (174 to 49). These figures demonstrate a change in the management of benign breast disease, from surgery with histopathological diagnosis t o cytological diagnosis with surgery only if indicated clinically or f rom imaging.