Lack of utility in clinical practice of cytologic examination of nonbloody cyst fluid from palpable breast cysts.

OBJECTIVE: This study was undertaken to answer the following question: Does cytologic evaluation of nonbloody fluid aspirated from breast cysts contribute to appropriate clinical management? STUDY DESIGN: A retrospective review of palpable breast cyst fluid cytologic reports and associated medical records was undertaken to determine whether the cytologic findings affected patient management. Breast cyst size, fluid volume, fluid color, and patient age were abstracted from 689 medical records (1988-1999) of women whose palpable cysts had been aspirated at the Breast Diagnostic Center, Women's and Children's Hospital, Los Angeles. These observations were correlated with the fluid cytologic reports. RESULTS: Except for frankly bloody fluid, all breast fluid cytologic reports listed the results as acellular, inadequate for cytologic diagnosis, or no malignant cells identified. CONCLUSION: In clinical practice only frankly bloody fluid should be submitted for cytologic analysis. All other cyst fluid should be discarded.