CORE NEEDLE-BIOPSY - A USEFUL ADJUNCT TO FINE-NEEDLE ASPIRATION IN SELECT PATIENTS WITH PALPABLE BREAST-LESIONS

BACKGROUND. Fine-needle aspiration (FNA) biopsy is an established, hig hly accurate method for diagnosing palpable breast lesions. However, i n some cases a definitive diagnosis cannot be made by FNA alone, eithe r due to the inherent limitations of cytology itself or the ability to obtain adequate material for diagnosis. This study evaluated the usef ulness of a supplemental core needle biopsy performed by a cytopatholo gist in conjunction with an FNA biopsy in select patients. METHODS, Tw elve patients with palpable breast lesions underwent the combined FNA/ core needle biopsy procedure during the study period from March 1995 t hrough March 1996. All 12 patients first had an FNA aspiration that wa s preliminarily evaluated by the FNA cytopathologist while the patient was at the clinic. If the cytopathologist was unable to render a defi nitive diagnosis of the lesion type or if a repeat FNA was requested b y the clinician because of a previous non-definitive FNA result, a cor e needle biopsy was then performed. RESULTS. When the FNA and the core needle biopsies were reviewed together, a correct definitive diagnosi s was made in IO of the 12 cases. In contrast, review of the FNA mater ial alone yielded a correct definitive diagnosis in only five cases. C ONCLUSIONS. The supplemental core needle biopsy was found to be especi ally useful in: I) providing a definitive diagnosis of infiltrating ca rcinoma in those cases in which the FNA diagnosis was reported as ''su spicious;'' 2) providing ample tissue for ancillary studies; and 3) di fferentiating a phyllodes tumor from a fibroadenoma. It is the authors ' opinion that the FNA cytopathologist is the physician best qualified to perform the combined FNA/core needle biopsy procedure should he/sh e deem it necessary. (C) 1997 American Cancer Society.