Impact of inadequate fine-needle aspiration cytology on outcome of patients with palpable breast lesions

Background: The purpose of the present study was to assess the impact of in adequate fine-needle aspiration cytology (FNAC) breast specimens on the out come of patients with a palpable breast lesion. Methods: A retrospective review was carried out of inadequate FNAC specimen s from the Department of General Surgery, Singapore General Hospital in 199 7. Results: One hundred and thirty-eight (16.6%) of 831 FNAC specimens were re ported inadequate, and these form the study group. Outcome analysis was div ided into benign on excision biopsy (n = 38; 29.4%); benign on repeat FNAC or trucut biopsy (n = 6; 4.7%); benign on follow up (n = 46; 35.7%): malign ant on histology (n = 11; 85%); and lost to follow up (n = 28: 21.7%), The 11 cases with breast cancer were further analysed. The mean time to treatme nt was 88.3 days for three patients whose tumours were not clinically suspi cious of malignancy versus 20 days for six patients who were diagnosed with cancer clinically from the onset. One patient with cancer refused treatmen t and one absconded from treatment only to return 7 months later, Conclusion: Breast cancer was present in 8.5% of the inadequate FNAC specim ens. When clinical suspicion of malignancy is high, an excision biopsy is a dvised in patients with inadequate FNAC specimens. If properly managed with triple tests and good clinical judgement, the inadequate FNAC specimens do not delay treatment in patients with breast cancer.