Role of fine-needle aspiration cytology in nonpalpable mammary lesions: A comparative cytohistologic study based on 308 cases

We retrospectively evaluated the accuracy of fine-needle aspiration cytolog y (FNAC) in nonpalpable breast lesions detected by imaging techniques betwe en 1995-1997. A total number of 308 lesions was investigated: 273 had been studied by means of either FNAC obtained under ultrasound (175 cases) or st ereotactic guidance (98 cases). The overall sensitivity rate was 87.8%; spe cificity was 95.3%; the positive predictive value was 76.6%; the negative p redictive value was 97.8%. Our results confirm that FNAC is quite effective in the approach to patients with nonpalpable breast lesions. It is particu larly accurate in diagnosing malignancy, although a lower yield may be enco untered in tumor types producing a desmoplastic stroma (tubular carcinoma, infiltrating lobular carcinoma) or in noncomedonic in situ ductal carcinoma . Discrepancy between a suspicious cytology and a negative histology is mor e frequent with benign lesions usually because olf sampling mistake or tech nically inadequate smears. In particular, when smears are adequate, FNAC sa fely assists in ruling out the malignant lesions. Diagn. Cytopathol. 2000;2 3:87-91. (C) 2000 Wiley-Liss, Inc.