[Cytopathology of the breast. 2. Puncture cytology]

The fine needle aspiration cytology of the breast is the only way for the morphological examination of suspicious palpable lesions without surgical procedure. The cytological examination is able to produce clinical relevant results on the basis of typical microscopical pictures especially in breast carcinoma, fibroadenoma, and cysts. However it must be taken into account that not all breast tumors can be detected by fine needle aspiration cytology. Therefore negative and doubtful results have to be interpreted in connection with clinical and mammographic findings. An essential condition for good results is an effective punction technique to obtain representative probes of cell material. In case punction and cytological examination are not performed by the same investigator there is the risk that an inadequate punction technique is not noticed and leads to unsatisfactory cytological results. In connection with clinical and mammographic examinations the fine needle aspiration cytology can be used as alternative diagnostic way and replace the conventional breast tumor diagnostic procedure by surgical biopsy and frozen section, if the necessary requirements are fulfilled. This includes a high standard of clinical, mammographic and cytological examinations and a critical summarizing interpretation of the examination results.