Role of combined fine needle aspiration and ultrasonography in the diagnosis of impalpable lesions of the breast.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of combined fine needle aspiration (FNA) and ultrasonography in the diagnosis of impalpable breast lesions. METHOD: To analyze the diagnostic performance of the FNA cytology and ultrasound among female patients with impalpable breast lesions that were referred to the FNA clinic at King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand during the period of July 2001 to June 2002. The final diagnoses employed surgical pathology and 6-month follow-up of the patients. RESULT: In a-year-period of the studied frame, there were 57 studied cases (18.3% of the total FNA breast cases). To diagnose malignant lesions, FNA cytology achieved the sensitivity of 61 per cent and the specificity of 100 per cent, whereas, diagnostic radiology had a sensitivity of 100 per cent and specificity of 56.1 per cent. The FNA cytology was superior to ultrasound in the determination of inflammatory lesions while imaging was dominant in the hard-to-aspirate malignant lesions. Therefore, the combined cyto-radiology criteria could correctly diagnose malignancy in all cases (100% accuracy). CONCLUSION: The efficacy of combined FNA and ultrasonography in the diagnosis of impalpable breast lesions was highly satisfactory. The accuracy of each technique enhanced each other and gave the correct diagnosis in all cases.