Accuracy of combined clinical findings and fine needle aspiration cytologyfor the diagnosis in palpable breast tumors

Objective. A prospective study to evaluate the confidence level and predict ive value of the fine needle aspiration biopsy was performed in the Oncolog y Service, "Hospital 20 de Noviembre, ISSSTE", Mexico City. Material and me thods. The cases with a palpable breast tumor, histologically confirmed who presented from 1992 to 1994 were included. One aspirate was done in each p atient and these were reviewed by the same pathologist. We determined sensi tivity, specificity and predictive value of the test. Age, border character istics, size and mobility of the tumor were evaluated by Bayesian analysis. Results. From 213 aspirates, 199 were elegible for diagnosis, 98 (46%) had a diagnosis of; carcinoma, 13 were acellular and one suggestive. The acell ular diagnoses were considered negative and suggestive positive, for analys is purposes. Mean age and tumor size were: 46.6 years (range 14-90) and 3.7 cm. (range 1-13) respectively. Sensitivity (0.932), specificity (0.973) an d positive predictive value (96.9%) were estimated. We observed a high prob ability of true positive [P(D +/T+)] > 0.8 results in patients between 40 a nd 60 years of age, irregular borders, size > 2 cm and fixed lesions. Concl usions. The test has a high confidence level and in presence of two or more of the clinical factors mentioned, definitive decisions regarding treatmen t could be taken, without need of histologic confirmation.