ABSTRACT
The increased use of mammography for the detection of impalpable breast lesions has resulted in a need for new diagnostic techniques. In a prospective study of 261 occult breast lesions, aspiration biopsy was done with a standard fine needle and syringe. This "scouting needle" technique permits the collection of diagnostic cytologic material in the clinician's office without specialized radiologic equipment. Thirty of 53 malignant lesions (57%) were detected cytologically. A benign cytologic diagnosis, which was made in 220 patients, did not preclude additional investigation. Aspiration biopsy using the "scouting needle" is a rapid, low-cost, easily performed, initial procedure which complements "watchful waiting." When diagnostic of carcinoma, it results in immediate surgical intervention and may obviate two-stage surgical treatment.
Subject(s)
Biopsy, Needle/methods , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Calcinosis/pathology , Carcinoma/pathology , Carcinoma in Situ/pathology , False Negative Reactions , Female , Humans , Prospective Studies , Retrospective StudiesABSTRACT
Intraoperative fine needle aspiration biopsy (NAB) of undiagnosed pancreatic masses was studied in 166 patients over a 17-year period. The cytologic diagnoses were correlated with histologic specimens, autopsy results, or clinical follow-up (benign disease was documented if the patient was alive without malignancy at least 2 years after laparotomy). Aspirates were interpreted as benign, suspicious, malignant, or unsatisfactory. Malignant disease was the final diagnosis in 109 patients; the cytology was concordant in 101 and was interpreted as suspicious in four. Four patients with benign cytology later proved to have malignant disease--a false-negative rate of 2.5 per cent. A total of 57 patients had benign disease; 51 of these had benign cytology. The remaining patients had "unsatisfactory" cytology reports. A 93 per cent sensitivity, 100 per cent specificity, and 0 per cent complication rate are reported. There were no false-positive cytology reports. Complications are rare and represent case reports, thus, additional sampling is at minimal risk. Intraoperative pancreatic NAB is a safe, easy, more accurate biopsy technique than historical wedge or core needle biopsies. It is the biopsy method of choice for pancreatic masses found at laparotomy.
Subject(s)
Biopsy, Needle/standards , Intraoperative Care , Pancreatic Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Biopsy, Needle/instrumentation , Biopsy, Needle/methods , Evaluation Studies as Topic , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/epidemiology , Sensitivity and SpecificitySubject(s)
Biopsy, Needle , Carcinoid Tumor/pathology , Liver Neoplasms/pathology , Staining and Labeling , Cytodiagnosis , Humans , Male , Microwaves , Middle AgedABSTRACT
This work has been based on 15 years experience with more than 10,000 needle aspiration biopsies of the breast. Fine-needle aspiration biopsy was used in place of open breast biopsy for definitive operation in breast cancer. Our experience with 2,623 aspiration biopsies over a 3 year period has been reviewed. There was a total of 323 cancers, of which 257 (80 percent) were unequivocally diagnosed by fine-needle aspiration biopsy. Definitive operation was performed in 244 of these patients (95 percent) without open biopsy. Thirteen had an excisional biopsy before definitive operation at the request of the referring physician. The sensitivity was 80 percent and the specificity was 98 percent. There were no false-positive diagnoses. The positive predictive value was 100 percent. False-negative diagnoses were made in 9 percent of the patients, half of whom had nonpalpable carcinomas. Our experience shows that fine-needle aspiration biopsy is accurate in the diagnosis of breast cancer, and when the finding is positive, it can be used for definitive breast operation, eliminating the need for open biopsy. A management algorithm has also been presented herein.
Subject(s)
Breast Neoplasms/pathology , Breast/pathology , Algorithms , Biopsy, Needle , Breast Neoplasms/surgery , False Negative Reactions , Female , Humans , Preoperative CareABSTRACT
The effect of surgical technique on hormone receptor values in breast cancer tissue was examined. One hundred and thirty-one women with breast cancer were divided into three groups: Group I, definitive diagnosis at frozen section and tissue taken for receptor determination; Groups II and III, diagnosis made by aspiration biopsy cytology, with tissue obtained from modified radical mastectomy in Group II and tissue obtained from mastectomy performed separately, prior to axillary lymph node dissection, in Group III. The rates of estrogen and progesterone receptor positivity, and the mean levels of receptor, did not differ significantly among the three groups. Thus tumor tissue from a mastectomy specimen can be reliably used for hormone receptor determinations, if the tumor tissue is kept cold and rapidly frozen for storage. Women whose cancer has been diagnosed by aspiration biopsy cytology need not undergo an additional open biopsy solely to obtain tissue for receptor determinations.
Subject(s)
Breast Neoplasms/metabolism , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Axilla , Biopsy , Breast Neoplasms/surgery , Female , Frozen Sections , Humans , Lymph Node Excision , Mastectomy , Specimen HandlingABSTRACT
Fine-needle aspiration is now a recognized diagnostic tool. In the past eight years we have studied 3545 aspirates from the breast, including both cystic and solid masses. All were prepared according to the method of Papanicalaou. The cellular findings are described and discussed. Abnormal cells were found in the aspirates from 90% of the 368 malignancies. Reliable criteria for diagnosis are emphasized and diagnostic pitfalls discussed. Aspiration biopsy was helpful in the management of all patients with breast lesions. The method is rapid, accurate, and essentially complication-free. It should be used with the idea of complementing, not competing with, routine histologic biopsy.
Subject(s)
Biopsy, Needle , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , Adenofibroma/diagnosis , Adult , Aged , Carcinoma, Intraductal, Noninfiltrating/diagnosis , False Negative Reactions , False Positive Reactions , Female , Fibrocystic Breast Disease/diagnosis , Gynecomastia/diagnosis , Humans , Male , Middle AgedABSTRACT
Fine-needle aspiration biopsy was used to diagnose lesions from the breast, subcutaneous nodules and lymph nodes, prostate, deep masses, lung, and pancreas. Over an eight-year period, 3,267 specimens were examined. The biopsy specimens were taken with 18- to 22-gauge disposable needles with attached syringes, were fixed immediately, and were stained according to the method of Papanicolaou. Frequently, the aspiration was done as an office procedure. The method was essentially complication-free. The biopsy specimen was easy to interpret, and the procedure had an overall accuracy of approximately 90%. It should be used by all clinicians, especially on the initial visit of the patient.
Subject(s)
Biopsy, Needle , Biopsy, Needle/instrumentation , Biopsy, Needle/methods , Breast/pathology , Evaluation Studies as Topic , Female , Humans , Lung/pathology , Lymph Nodes/pathology , Male , Neoplasms/pathology , Pancreas/pathology , Prostate/pathology , Salivary Glands/pathologyABSTRACT
Thin needle aspiration biopsies obtained from the pancreas during laparotomy have been taken on 56 patients over the past six years. An 18- to 22-gauge spinal needle attached to a disposable syringe was employed. The specimens were fixed immediately and stained according to the method of Papanicolaou. Of the 36 carcinomas, the accuracy was 94%; there were no false positives in the 20 benign lesions. The safety, ease of interpretation and high accuracy of this method make this an extremely useful procedure.
Subject(s)
Biopsy, Needle/methods , Pancreas/pathology , Pancreatic Neoplasms/pathology , Carcinoma/pathology , Diagnosis, Differential , Humans , Laparotomy , Neoplasm MetastasisABSTRACT
Needle aspiration biopsy for the examination of breast nodules is an accurate uncomplicated and rapid procedure. Of 1168 cases so examined, 127 were malignant with abnormal cells in 114. Case studies suggest that this procedure should be utilized in all palpable breast masses.
Subject(s)
Biopsy, Needle , Breast Diseases/pathology , Breast Neoplasms/pathology , Adult , Aged , Breast Diseases/diagnosis , Breast Neoplasms/diagnosis , False Positive Reactions , Female , Humans , Middle AgedABSTRACT
Needle aspiration biopsies were performed on 130 patients with lymphadenopathy or subcutaneous nodules. Within this group, there were 88 malignant specimens, with 84 interpreted as positive and four as suspicious. There were no false-positive findings in benign-lesion speciemens. The method is rapid, inexpensive, and relatively atraumatic and can be utilized in lieu of ordinary surgical excision.
Subject(s)
Biopsy, Needle , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Lymphoma/pathology , Skin Neoplasms/diagnosis , Biopsy, Needle/instrumentation , Breast Neoplasms/diagnosis , Evaluation Studies as Topic , Female , Humans , Lymphatic Diseases/diagnosis , Lymphatic Diseases/pathology , Lymphoma/diagnosis , Male , Melanoma/diagnosisABSTRACT
Needle aspiration of a breast mass, a procedure widely employed in Scandinavia but neglected in the United States, has an imporant role in the diagnosis of carcinoma of the breat. Five hundred and ninety-seven patients has aspirations from 706 lesions, 415 solid and 291 cystic. There were 83 malignancies, with abnormal cells in 73. In the majority the diagnosis could be made readily. There is no known contraindication to the procedure. Aspiration at the initial visit may alert the physician to malignancy, thus avoiding undue delay in treatment.
Subject(s)
Biopsy, Needle , Breast Neoplasms/diagnosis , Breast/pathology , Carcinoma/diagnosis , Breast Neoplasms/pathology , Carcinoma/pathology , Female , Humans , MammographyABSTRACT
Thin-needle aspiration biopsy of the pancreas is a safe, accurate procedure that may be used for immediate diagnosis at the time of laparotomy. Twenty-eight aspiration biopsies of the pancreas were examined. Of the 18 cases of carcinoma, 16 were correctly diagnosed, one was considered atypical, and no abnormal cells were seen in one specimen. All ten of the cases diagnosed as benign are apparently free of pancreatic malignancy. The tumor cells are easily identifiable. No complication followed the procedure.
