Needle aspiration of the breast

Using a 20- or 22-gauge needle and a 20.0 ml syringe attached to a commercially available syringe pistol, the author performed 853 aspiration biopsies of palpable breast masses during the 9-year period 1974 through 1982. There were 269 diagnoses of breast cancer, 42 suspected cases of cancer, and 496 aspirates reported as benign tumor, inflammation, or another non-neoplastic diagnosis. Twenty-seven cases of carcinoma were not diagnosed from the aspiration biopsy sample. There was one false-positive diagnosis of carcinoma in a patient whose tumor was a cystosarcoma phylloides, benign variant. Forty-six aspirates were considered unsatisfactory, usually because of an insufficient cellular sample. Sensitivity for the diagnosis of breast cancer was 89.0%, while specificity for the absence of breast cancer was 97.0%. Only 13 cases in the group reported as suspicious for carcinoma were proven not to be breast cancer after excisional biopsy and histologic study. The procedure is free of complications, convenient, and cost effective. It provides for evaluation of the patient who has breast cancer on an outpatient basis as well as a full discussion of treatment options prior to intervention.