The Clinicopathologic Factors Affecting the False Negativity of Fine Needle Aspiration Cytology (FNAC) in Breast Cancer

ABSTRACT

PURPOSE: The aim of this study was to understand the diagnostic false negative outcome of FNAC at the first clinic visit of patients in relation to various clinicopathological factors with the uni- and multivariate analysis. METHODS: From January 1993 to October 2001, the one hundred and twenty-one cases of primary palpable breast cancers which were diagnosed by FNAC were reviewed retrospectively. RESULTS: The ages of the patients varied from 24 to 84 (mean age was 51.3 years). Ten clinicopathological factors correlating with failure or success of FNAC were analyzed. In univariate analysis, statistical significances were observed in palpability (P<0.001), tumor size (P<0.001), histopathologic type (P<0.001), cellular distribution (P=0.002), TNM staging (P=0.042), mammographic findings (P<0.001). On the other hand, other factors such as age, ultrasound findings, extent of tumors, ER status, aspiratiors did not reveal any statistical significance. In multivariate analysis, palpability (P=0.002), histopathologic type (P=0.0457), mammographic findings (P=0.0161) were observed significantly. CONCLUSION: The most important factors for concerning diagnostic failure by FNAC seemed to be summarized into clinically palpability, histopathologic type, mammographic findings, inexperience and number of aspirator were also considered as a factor of diagnostic failure. In rare carcinomas such as lobular carcinoma and DCIS, high false negative rate was identified.