Experience with a modified fine-needle aspiration biopsy technique in 533 breast cases

Aspiration cytology depends on skillful preparation of smears, which normally requires a trained cytotechnologist. Collection of aspirates into Saccomanno fixative permits preparation of high-quality smears by trained technologists no matter who does the aspiration. Aspiration by a surgeon was used with palpation and mammography to examine 533 patients in an office-based regional breast health program. Lesions sampled ranged from diffuse thickening to frank tumors. Lesions suspicious to any one of the three examinations were biopsed. Cytologically diagnosable material was obtained in 349 instances: 120 were malignant, 22 suspicious, 12 atypical, and 195 benign. Of the 184 yielding insufficient cells, 116 were benign on palpation and mammography, and 68 were suspicious. Biopsy proved 57 of these benign and 11 malignant. There were no cytologic false positives in the study. There was a 2% false-negative rate on productive aspirates. Nonproductive aspiration occurred in 4.8% of malignant cases.