BREAST INTRADUCTAL MASSES - US-GUIDED FINE-NEEDLE ASPIRATION AFTER GALACTOGRAPHY

PURPOSE: To evaluate ultrasonographic (US)-guided fine-needle aspirati on (FNA) of intraductal masses performed immediately after galactograp hy and to compare cytologic findings from US-guided FNA with those fro m nipple discharge. MATERIALS AND METHODS: In 36 patients with nipple discharge from a single duct in one breast and intraductal masses diag nosed at galactography, US was performed to detect intraductal lesions and perform FNA before removal of the galactographic catheter. Cytolo gic analysis of nipple discharge, excisional biopsy, and histopatholog ic evaluation were performed in all patients. RESULTS: Cytologic analy sis revealed 23 nonpapillary benignancies, seven papillomas, five inde terminate cases, and one carcinoma. US-guided FNA cytologic analysis r evealed 16 papillomas, 10 nonpapillary benignancies, five indeterminat e cases, and three carcinomas. The two carcinomas misdiagnosed as papi llomas at US-guided FNA cytologic analysis were papillary in situ carc inomas, while the three carcinomas correctly identified were invasive (only one was detected with cytologic analysis of nipple discharge). W ith cytologic analysis of nipple discharge, nine (25%) of 36 diagnoses were correct, and with US-guided FNA, 18 (50%) were correct (P = .035 2). CONCLUSION: Compared with cytologic analysis of nipple discharge, US-guided FNA cytologic analysis seems to add useful information for t ailored surgical planning.