Aspiration biopsy cytology of occult breast lesions by use of the "scouting needle": a prospective study of 261 cases

Article Abstract:

Routine mammography is now recommended for the early detection of breast cancer. As mammography use becomes more widespread, more and more tiny, impalpable lesions will be found. Every suspicious lesion must be evaluated, but the best method for doing so is not certain. If a breast lesion is too small to be felt, the only means of obtaining a true needle biopsy is to use mammography, or another imaging method, during the biopsy to guide the placement of the needle. This is possible only in locations where the imaging equipment is available. One alternative to the use of guided needle aspiration biopsy is the use of the 'scouting needle'. With this method, a standard needle and syringe is used to draw some cells from the approximate location of the impalpable mass. In a study of 261 breast lesions, this method of needle biopsy was successful in identifying 30 of the 53 lesions that eventually proved to be malignant. This 57 percent sensitivity is significantly lower than that achieved with other biopsy methods. However, the use of the scouting needle technique does not preclude the use of other diagnostic methods. Therefore, when a patient has a tiny mass visible on mammography but not palpable, a positive result on the scouting needle biopsy is a reliable indicator of malignancy, and such patients may be prepared for surgery. However, when the result of the scouting needle biopsy is negative, further evaluation of the patient is required. The most attractive features of the scouting needle biopsy are the low cost, the ease of performance, and the adaptability of the technique to any setting. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Examinations, Test validity

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The male breast and malignant neoplasms: diagnosis by aspiration biopsy cytology

Article Abstract:

Some breast masses are examined for signs of malignancy by aspiration biopsy. In this procedure, a small amount of tissue is sucked through a needle and examined. However, while much experience has been gained examining the cells from female breasts, there are few studies on the material aspirated from lumps in male breasts and how malignant growths might be distinguished from other conditions, such as gynecomastia. While breast cancer is rare among men, it is not negligible; each year 600 new cases are diagnosed in the US, and about 250 men die from the disease. Fourteen cases of male breast cancer, identified from among 188 aspiration biopsies performed for gynecomastia, or enlargement of the male breast, were examined. Ten cases were classified as infiltrating ductal carcinoma and one was a mucinous carcinoma. The remaining three were metastatic tumors that had spread from other parts of the body. The cytopathological appearance of the cancers was readily distinguished from that of gynecomastia. The cancer specimens had many cells of uniform appearance and little adhesion between the cells. In contrast, the specimens from patients found to have gynecomastia had fewer cells and cohesive cell clusters. Male breast cancer is so rare that diagnosis may be delayed. Since the condition is readily identified by aspiration biopsy, a procedure quickly and easily performed in the doctor's office, aspiration biopsy cytology (ABC) should become the routine initial procedure for breast masses in men. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Breast, Breast biopsy, Carcinoma, Ductal, Ductal carcinoma

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Medullary carcinoma of the breast: an unusual cytologic finding in cyst fluid aspirates

Article Abstract:

When a breast mass is first noticed, a common diagnostic procedure is the fine-needle aspiration biopsy. The majority of these lumps are not cancerous; many are benign cysts caused by fibrocystic disease. Since malignant tumors form cysts infrequently, cystic fluid retrieved at biopsy often is not examined unless there is some other suspicious indication such as bloody fluid, a residual mass after cyst collapse, or refilling of the cyst. However, in five young women with medullary carcinoma presenting as a cyst, two patients had no suspicious signs, suggesting that misinterpretation of a cancer as a inflamed cyst may occasionally occur. Although examination of the cystic fluid from all biopsies would reduce the chance of mistaking a cancerous tumor for a benign cyst, the procedure is time-consuming and expensive, especially considering the infrequency of malignant cysts. In conclusion, while premenopausal women are more likely to have a benign than a malignant cyst in the breast, the possibility that a patient has the rare cystic medullary carcinoma should be considered, and fine-needle aspiration biopsy can aid in the differential diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Cysts

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