[Ultrasound-guided fine-needle aspiration of the breast]

Retrospective analysis of the results of all ultrasound (US)-guided fine needle aspirations (FNA) of the breast performed at our institution between 1988-2002.

The radiologic and pathologic information database was retrospectively searched for all referrals, in whom an US-guided FNA of the breast was performed as further diagnostic work-up of sonographically unclear or suspicious findings. Percutaneous tissue diagnosis was performed under US-guidance using a 20-Gauge-needle. Results were correlated with histology or sonographic and/or mammography follow-up examination, respectively.

The total study population consisted of 324 patients (19-92 years). In 20 cases (6.2%), results of FNA were non-diagnostic, a cytologic diagnosis was established in the remaining 304 (93.8%) cases. Cytologically, malignancy was diagnosed in 60 cases; 2 of those were shown to be false positive by subsequent histologic work-up. In 33 of 244 surgery was performed. 9 cases were false negative. No complication was observed. The accuracy was 96.4% with a sensitivity of 86.6% and specificity of 99.2%.

If a skilled cytopathologist is available, US-guided FNA is a highly accurate and minimal-invasive technique. False negative findings may occur, thus clinical and imaging findings should be taken into account for further therapeutic decision.