The diagnosis and management of pre-invasive breast disease: the role of new diagnostic techniques.

Ashutosh Nerurkar,Peter Osin

doi:10.1186/bcr721

Abstract

In recent years we have seen significantly increased use of minimally invasive diagnostic techniques in the management of breast disease. There is wide recognition of fine needle aspiration and core biopsy as the principal diagnostic methods. However, concerns exist regarding their reliability. This article provides a brief overview of the major diagnostic issues related to use of fine needle aspiration, core biopsy and ductal lavage. It summarizes areas of use for each technique, outlines the main diagnostic pitfalls and their causes, and provides a perspective on future developments in the field.

Highlights

The introduction of breast screening programmes led to wider employment of minimally invasive diagnostic methods
Fine needle aspiration (FNA) and core biopsy are universally accepted as methods that virtually eliminate the need for open biopsy or frozen sections in diagnosis of breast cancer
It was initially introduced to replace incisional biopsy, which is an invasive method. Over this period the technique has been used extensively for the diagnosis of breast lesions, and it forms an integral part of the triple approach to management of breast cancer

Summary

Introduction

The introduction of breast screening programmes led to wider employment of minimally invasive diagnostic methods. Alongside FNA and core biopsy, a number of noninvasive methods of sampling breast epithelium have recently attracted increased interest both from researchers and clinicians [20,21]. These methods include ductal lavage, ductoscopy and examination of spontaneous nipple discharge. In a recent study conducted by Irfan and coworkers [18], 14.3% of the papillary lesions diagnosed on stereo core biopsy demonstrated cancer on subsequent excision All of these problems cause great difficulty in the diagnosis of papillary lesions, and papillary lesions should be completely excised, regardless of cytological and architectural atypia. Other articles in the series can be found at http://breast-cancer-research.com/articles/reviewseries.asp?series=bcr_Thediagnosis

Conclusion

Orell SR

Findings

22. Domchek SM