THE USEFULNESS AND LIMITATION OF ASPIRATION BIOPSY CYTOLOGY IN THE DIAGNOSIS OF BREAST CANCER

Abstract

A total of 303 operated patients with breast cancer who underwent aspiration biopsy cytology (ABC) for preoperative diagnosis in the institute from January 1986 to September 1991 were examined for tumor factors responsible for false negative cytology (suspicious, negative or unsatisfactory) and problems relating to the diagnostic accuracy of ABC were evaluated. The results of ABC diagnosis were positive in 82%, suspicious in 12.3%, negative in 1.4% and unsatisfactory in 4.3% of the patients. There was a significantly higher rate of suspicious as compared to positive in the following five tumor factor categories: tumor size less than 2.1cm, noninvasive carcinoma, histological grade, fat infiltration and vessel invasion. Hence, it is suggested that there is a high likelihood of false negative in ABC diagnosis of small tumors, because it may easily complicate with technical failure in aspiration and these tumor factors may be responsible for suspicious aspirations. Furthermore, without regard to tumor size, tumor factors such as histological grade, fat infiltration and vessel invasion might also be responsible for suspicious aspirations. The use of the oil-immersion lens in the microscopic diagnosis of low-grade nuclear atypism and the combination of ABC and ultrasound examination as supplemental diagnostic method might make up for the limitations of ABC diagnosis and increase the diagnostic accuracy of breast cancer.