PREOPERATIVE DIAGNOSTIC-ACCURACY OF FINE-NEEDLE ASPIRATION IN THE MANAGEMENT OF BREAST-LESIONS - COMPARISON OF SPECIFICITY AND SENSITIVITY WITH CLINICAL EXAMINATION, MAMMOGRAPHY, ECHOGRAPHY, AND THERMOGRAPHY IN 249 PATIENTS

Two hundred and forty-nine women suffering from breast problems underw ent a complete series of tests including clinical examination, mammogr aphy, echography, thermography, and fine-needle aspiration (FNA). Nine ty-four of these patients were shown to be positive or to have suspect ed malignancy. Accordingly, they underwent surgical excision followed by histologic examination, while the remaining patients were re-examin ed after 12 to 18 mo in order to exclude false negatives. The analysis of specificity and sensitivity of every single procedure showed that FNA describes the best degree of sensitivity and specificity but no pr ocedure allows, by itself the detection of all carcinomas. When consid ered in combination, clinical examination, mammography, and fine-needl e aspiration have a sensitivity of 100% and a specificity of 49%, and are the best diagnostic tests for a correct assessment of mammary lesi ons. Thermography and echography showed a low degree of sensitivity an d should not be included in the routine diagnostic procedure of breast lesions. (C) 1994 Wiley-Liss, Inc.