PURPOSE: To evaluate retrospectively the findings at ultrasound (US)-g
uided fine-needle aspiration biopsy (FNAB) of masses in breasts that c
ontain a prosthesis. MATERIALS AND METHODS: Realtime US-guided FNAB wa
s performed in 22 lesions in 17 patients with breast implants. Pneumoc
ystography was performed in seven of eight cysts. The final diagnosis
was based on either histologic findings after surgical excision or a c
ombination of cytologic, imaging, and clinical findings. RESULTS: The
lesions had a mean diameter of 15 mm +/- 9 (standard deviation). Fifte
en lesions (68%) were not identified on mammograms. In all cases, FNAB
was completed without complication. Pneumocystography was successful
in seven of seven cysts. Cytologic diagnosis was correct in 21 of 22 l
esions (95%). There was one ease of inadequate specimen (5%). In 16 ca
ses (73%), the diagnosis was established with a single pass. CONCLUSIO
N: Real-time US allowed continuous visualization of the needle during
insertion and sampling, which resulted in pinpoint accuracy and safety
. US-guided FNAB is recommended for needle biopsy in breasts with impl
ants.