Unsatisfactory aspirates from fine-needle aspiration biopsies: a review

While there is much evidence that fine-needle aspiration biopsy (FNAB) is sensitive and specific, there is little information comparing the proportions of unsatisfactory aspirates obtained by clinicians or pathologists. We reviewed 2,199 FNAB reports of superficial lesions. Cases were grouped by organ/site and according to who performed the biopsy. The proportions of unsatisfactory aspirates were computed for clinicians and pathologists. Both groups performed approximately equal numbers of procedures. Overall, 9% of aspirates obtained were unsatisfactory (n = 191). Pathologists had lower proportions of unsatisfactory aspirates in all sites. Of aspirates obtained by clinicians, 14% were unsatisfactory, compared to 3% of those obtained by pathologists (P < .00001). The proportion of unsatisfactory aspirates appears to decrease as physician experience increases, and pathologists may have more experience with FNAB than do clinicians. Other advantages pathologists may have include technique and working with tissue regularly. Both clinicians and pathologists can expect to decrease their proportions of unsatisfactory aspirates by performing FNABs frequently.