Benign breast aspirates: two decades of experience

To evaluate the reliability of benign breast aspirates.

A 20-year retrospective study of cytologically benign aspirates from palpable breast lesions followed by surgery and review of false negatives.

Data encompassed 1518 benign aspirates followed by benign histology, and 99 by malignant histology. Of the latter, 89% underwent biopsy within 1 month. Review of 52 available false negatives revealed 10 (19%) with no change in the original diagnosis, 16 (31%) reviewed as unsatisfactory specimens, and 26 (50%) reviewed as specimens with focal cytologic atypia (dyshesion, nuclear enlargement, and contour irregularity). Cellularity (>20 epithelial groups per slide) was an important criterion in postmenopausal women.

Our study confirms the reliability of benign breast aspirates interpreted in light of clinical and mammographic findings and demonstrates the importance of adequacy evaluation and focal atypia in preventing false negatives.