[Evaluation of fine needle puncture of the breast mass]

Fine-needle aspiration (FNA) biopsy for cytology is an established, widely accepted, safe and very accurate method permitting morphological investigation of nodules within the breast. It represents an important part of the preoperative "triple diagnostic" which includes clinical examination, mammography and FNA. In a palpable malignancy, FNA permits a definitive diagnosis of cancer in 90-95% of the cases. False-positive results should be extremely rare (about 0.2%), whereas false-negative results cannot always be prevented (5-10%). This high accuracy of cytologic method, however, can be realized only under ideal conditions. If any possible, FNA should be performed by the cytologist himself in the cytology laboratorium; the possibility of direct clinical and anamnestic information, the optimal handling of the aspirated material, by necessity the immediate control of cells amount and preservation by quick stain, the immediate repetition of an insufficient aspiration within the same session: this are very important factors for diagnostic efficiency of cytologic method. If aspiration has to be performed outside the cytology laboratory, a close contact between the cytologist and the physician who performs aspiration is indispensable. If both (these possibilities) cannot be realized, the open surgical biopsy is considered as the best alternative to FNA.