PERFORMANCE OF FINENEEDLE ASPIRATION CYTOLOGY OF THE BREAST - CLINICAL-EXPERIENCE IN RAVENNA (ITALY)

Aims and background: Fineneedle aspiration cytology (FNAC) is a routin e test in the evaluation of breast lesions. We assessed the diagnostic accuracy of mammography (MG), physical examination (PE), ultrasonogra phy (US) and FNAC in 1064 histologically confirmed breast lesions (638 malignant, 426 benign) observed consecutively at the Cancer Preventio n Center of Ravenna (Italy). Methods: The performance of each test and the additional contribution of FNAC were determined. Results: FNAC wa s done in 69.6% of cancers and 39.7% of benign lesions (P = 0.00000), the frequency of aspiration being significantly associated with severi ty at MG, PE, and US. For FNAC, the true positive rate was 95.1% and t he true negative rate 67.4%. Only one breast cancer case was detected by FNAC alone (additional true positive rate 0.2%). The positive predi ctive value of FNAC in the absence of other abnormalities was 5%. The negative predictive value of a benign report at MG, PE, US and FNAC wa s 100%. Conclusions: All breast lesions should be evaluated by all ava ilable techniques, especially FNAC, and open biopsy should be avoided for those reported as benign at all tests.