FINE-NEEDLE ASPIRATION CYTOLOGY OF NONPALPABLE BREAST-LESIONS - ULTRASOUND VERSUS STEREOTAXIC GUIDANCE

The authors evaluated ultrasound (US)-guided fine-needle aspiration cy tology (FNAC) in 270 patients with suspicious findings at mammography. FNAC with a 10-MHz transducer and real-time scanner was performed whe n a lesion seen mammographically was unequivocally depicted at US. The needle was inserted with variable obliquity to the scanning plane. St ereotaxically guided FNAC was performed when lesions were not visible at US. High suspicion at mammography and positive cytologic reports le d to surgical biopsy. Of the 270 lesions, 120 (44.4%) were visible at US. Opacities were the most frequently visualized lesions. Inadequate samplings were most frequently reported for opacities with smooth marg ins. Differences in accuracy and inadequacy rate between the two modal ities were not significant. Cancer was surgically confirmed in 86 of 1 10 cases. The other 160 lesions were considered benign, and mammograph ic follow-up in 120 has shown no change. Because FNAC with US guidance was faster and less expensive, it is recommended as the technique of choice in lesions detectable with US.