BREAST CYTOLOGY - STATISTICAL-ANALYSIS AND CYTOHISTOLOGIC CORRELATIONS

OBJECTIVE: To analyze the sensitivity, specificity, positive and negat ive predictive values and the efficacy of fine needle aspiration (FNA) in our material, to investigate the influence of the histologic type and stage of carcinoma on the quality of the aspirates and on the dete ction rates of mammary carcinoma, and to investigate the rate of inade quate samples and the accuracy of cytologic diagnoses, with an emphasi s on the rate of false positive diagnoses in benign mammary lesions. S TUDY DESIGN: The results of 1,472 FNAs of the breast obtained over thr ee years were subjected to a retrospective analysis. RESULTS: The cyto logic diagnoses were benign in 1,003 cases (68.1%), suspicious in 49 ( 3.3%) and malignant in 181 (12.3%); 239 (16.2%) of the aspirates were inadequate. In 393 (26.6%) of the cases and in 85% of cytologically ma lignant smears, the aspirate was compared with histologic examination. The rate of false negative FNAs was 9.0%. The proportion of inadequat e cases' was clearly related to stage (pT): it was 9.5% in pT1, 5.0% i n pT2 and 0% in pT3. Among invasive carcinomas the sensitivity was 89. 9%, specificity 99.3% and overall accuracy 88.5%. Among the cases diag nosed cytologically as benign, 182 were compared with biopsies. Of the se, 79.9% were true negative, 0.5% (1 case) was false positive, and 15 .4% had insufficient cells for evaluation. CONCLUSION: FNA cytology ha s improved decision making and the selection of patients for biopsy of mammary lesions and has contributed to saving time in the clinical ma nagement of breast lumps. In no case did FNA lead to inadequate clinic al measures or other disadvantages to patients. Thus, FNA cytology is an indispensible diagnostic tool in the management of breast lesions.