Fine-needle aspiration of palpable breast masses. A program for staged implementation

Area of Science:

• Oncology
• Pathology
• Medical Education

Background:

• Fine-needle aspiration (FNA) is a valuable diagnostic tool for palpable breast masses, offering accuracy, efficiency, and safety.
• A significant gap exists in understanding the skill acquisition process for performing FNA and interpreting smears, particularly regarding patient safety and minimizing diagnostic errors.
• The need for a structured training methodology is evident to ensure competence and reduce the risks of false-positive or false-negative results.

Purpose of the Study:

• To develop and evaluate a systematic, three-phase training program for physicians to acquire proficiency in performing and interpreting fine-needle aspiration (FNA) of breast masses.
• To assess the feasibility and effectiveness of this graduated implementation program in achieving diagnostic accuracy comparable to experienced centers.
• To provide a practical educational framework for inexperienced physicians to safely and efficiently perform breast FNA.

Main Methods:

• A sequential, three-phase training program was implemented: in vitro practice, followed by in vivo practice on non-palpable lesions, and finally, in vivo application for clinical diagnosis.
• The program involved 205 patients over a 16-month period, focusing on gradual skill development and supervised practice.
• Training incorporated available literature and a graduated approach to build confidence and competence.

Main Results:

• Physicians with no prior FNA experience successfully acquired the necessary skills through the structured three-phase program.
• The program enabled inexperienced physicians to achieve diagnostic accuracy comparable to that of medical centers with extensive FNA experience.
• Patient data from 205 cases over 16 months demonstrated the practical application and success of the training methodology.

Conclusions:

• A structured, three-phase training program is effective in enabling inexperienced physicians to perform breast fine-needle aspiration (FNA) with high diagnostic accuracy.
• This graduated implementation approach mitigates risks associated with false-positive and false-negative results, enhancing patient safety.
• The developed training model offers a scalable solution for medical education, improving access to skilled FNA procedures in diverse clinical settings.