Skip to main content
NCBI home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1988 Jan;81(1):10–12. doi: 10.1177/014107688808100106

Use of ultrasound localization to improve results of fine needle aspiration cytology of breast masses.

J J Patel 1, P C Gartell 1, P B Guyer 1, A Herbert 1, I Taylor 1
PMCID: PMC1291418  PMID: 3278115

Abstract

A prospective randomized controlled trial of 116 patients with breast masses was conducted to compare the accuracy of 'blind' aspiration cytology performed in the clinic with aspiration cytology using ultrasound localization. The unsatisfactory aspiration cytology rate was significantly reduced by ultrasound localization (P = 0.028). This was mainly due to an improvement in the unsatisfactory rate for tumours less than 3 cm in diameter (P = 0.036). The results were influenced by the number of needle manoeuvres performed, less than 10 needle manoeuvres being associated with a 54% unsatisfactory aspiration rate compared with 25% when greater than 10 manoeuvres were performed (P = less than 0.02). One experienced aspirator in the clinic had results comparable to those achieved with ultrasound localization. It is concluded that experience and technique are the most important factors in obtaining a satisfactory aspirate from breast masses. Routine ultrasound localization prior to aspiration confers some benefit. Consideration should be given to the use of the ultrasound-assisted technique following a previous unsatisfactory aspiration, particularly if the tumour is less than 3 cm in diameter.

Full text

PDF
10

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell D. A., Hajdu S. I., Urban J. A., Gaston J. P. Role of aspiration cytology in the diagnosis and management of mammary lesions in office practice. Cancer. 1983 Apr 1;51(7):1182–1189. doi: 10.1002/1097-0142(19830401)51:7<1182::aid-cncr2820510703>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  2. Bolmgren J., Jacobson B., Nordenström B. Stereotaxic instrument for needle biopsy of the mamma. AJR Am J Roentgenol. 1977 Jul;129(1):121–125. doi: 10.2214/ajr.129.1.121. [DOI] [PubMed] [Google Scholar]
  3. Davies C. J., Elston C. W., Cotton R. E., Blamey R. W. Preoperative diagnosis in carcinoma of the breast. Br J Surg. 1977 May;64(5):326–328. doi: 10.1002/bjs.1800640507. [DOI] [PubMed] [Google Scholar]
  4. Dixon J. M., Anderson T. J., Lamb J., Nixon S. J., Forrest A. P. Fine needle aspiration cytology, in relationships to clinical examination and mammography in the diagnosis of a solid breast mass. Br J Surg. 1984 Aug;71(8):593–596. doi: 10.1002/bjs.1800710809. [DOI] [PubMed] [Google Scholar]
  5. Dixon J. M., Lamb J., Anderson T. J. Fine needle aspiration of the breast: importance of the operator. Lancet. 1983 Sep 3;2(8349):564–564. doi: 10.1016/s0140-6736(83)90585-8. [DOI] [PubMed] [Google Scholar]
  6. Dixon J. M., Lee E. C., Crucioli V. Frozen section of Tru-cut biopsies versus cytology. Br J Surg. 1986 Apr;73(4):324–325. doi: 10.1002/bjs.1800730427. [DOI] [PubMed] [Google Scholar]
  7. Duguid H. L., Wood R. A., Irving A. D., Preece P. E., Cuschieri A. Needle aspiration of the breast with immediate reporting of material. Br Med J. 1979 Jul 21;2(6183):185–187. doi: 10.1136/bmj.2.6183.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fleischer A. C., Muhletaler C. A., Reynolds V. H., Machin J. E., Thieme G. A., Bundy A. L., Winfield A. C., James A. E., Jr Palpable breast masses: evaluation by high frequency, hand-held real-time sonography and xeromammography. Work in progress. Radiology. 1983 Sep;148(3):813–817. doi: 10.1148/radiology.148.3.6878706. [DOI] [PubMed] [Google Scholar]
  9. Furnival C. M., Hocking M. A., Hughes H. E., Reid M. M., Blumgart L. H. Aspiration cytology in breast cancer. Its relevance to diagnosis. Lancet. 1975 Sep 6;2(7932):446–449. doi: 10.1016/s0140-6736(75)90855-7. [DOI] [PubMed] [Google Scholar]
  10. Goldberg B. B., Pollack H. M. Ultrasonic aspiration biopsy techniques. J Clin Ultrasound. 1976 Apr;4(2):141–151. doi: 10.1002/jcu.1870040219. [DOI] [PubMed] [Google Scholar]
  11. Guyer P. B., Dewbury K. C. Ultrasound of the breast in the symptomatic and X-ray dense breast. Clin Radiol. 1985 Jan;36(1):69–76. doi: 10.1016/s0009-9260(85)80028-3. [DOI] [PubMed] [Google Scholar]
  12. Harper A. P., Kelly-Fry E., Noe J. S., Bies J. R., Jackson V. P. Ultrasound in the evaluation of solid breast masses. Radiology. 1983 Mar;146(3):731–736. doi: 10.1148/radiology.146.3.6298858. [DOI] [PubMed] [Google Scholar]
  13. Jensen F. Procedure and principles in ultrasonically guided puncture. Ultrasound Med Biol. 1984 Sep-Oct;10(5):607–611. doi: 10.1016/0301-5629(84)90074-7. [DOI] [PubMed] [Google Scholar]
  14. Kehler M., Albrechtsson U. Mammographic fine needle biopsy of non-palpable breast lesions. Acta Radiol Diagn (Stockh) 1984;25(4):273–276. doi: 10.1177/028418518402500405. [DOI] [PubMed] [Google Scholar]
  15. Kopans D. B., Meyer J. E., Lindfors K. K., Bucchianeri S. S. Breast sonography to guide cyst aspiration and wire localization of occult solid lesions. AJR Am J Roentgenol. 1984 Sep;143(3):489–492. doi: 10.2214/ajr.143.3.489. [DOI] [PubMed] [Google Scholar]
  16. Kreuzer G., Boquoi E. Aspiration biopsy cytology, mammography and clinical exploration: a modern set up in diagnosis of tumors of the breast. Acta Cytol. 1976 Jul-Aug;20(4):319–323. [PubMed] [Google Scholar]
  17. Mushlin A. I. Diagnostic tests in breast cancer. Clinical strategies based on diagnostic probabilities. Ann Intern Med. 1985 Jul;103(1):79–85. doi: 10.7326/0003-4819-103-1-79. [DOI] [PubMed] [Google Scholar]
  18. Patel J. J., Gartell P. C., Smallwood J. A., Herbert A., Royle G., Buchanan R., Taylor I. Fine needle aspiration cytology of breast masses: an evaluation of its accuracy and reasons for diagnostic failure. Ann R Coll Surg Engl. 1987 Jul;69(4):156–159. [PMC free article] [PubMed] [Google Scholar]
  19. Smallwood J. A., Guyer P., Dewbury K., Mengatti S., Herbert A., Royle G. T., Taylor I. The accuracy of ultrasound in the diagnosis of breast disease. Ann R Coll Surg Engl. 1986 Jan;68(1):19–22. [PMC free article] [PubMed] [Google Scholar]
  20. Smallwood J., Khong Y., Boyd A., Guyer P., Herbert A., Cooke T., Taylor I. Assessment of a scoring scheme for the preoperative diagnosis of breast lumps. Ann R Coll Surg Engl. 1984 Jul;66(4):267–269. [PMC free article] [PubMed] [Google Scholar]
  21. Thomas J. M., Fitzharris B. M., Redding W. H., Williams J. E., Trott P. A., Powles T. J., Ford H. T., Gazet J. C. Clinical examination, xeromammography, and fine-needle aspiration cytology in diagnosis of breast tumours. Br Med J. 1978 Oct 21;2(6145):1139–1141. doi: 10.1136/bmj.2.6145.1139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Van Bogaert L. J., Mazy G. Reliability of the cyto-radio-clinical triplet in breast pathology diagnosis. Acta Cytol. 1977 Jan-Feb;21(1):60–62. [PubMed] [Google Scholar]
  23. Webb A. J. The diagnostic cytology of breast carcinoma. Br J Surg. 1970 Apr;57(4):259–264. doi: 10.1002/bjs.1800570405. [DOI] [PubMed] [Google Scholar]
  24. Wollenberg N. J., Caya J. G., Clowry L. J. Fine needle aspiration cytology of the breast. A review of 321 cases with statistical evaluation. Acta Cytol. 1985 May-Jun;29(3):425–429. [PubMed] [Google Scholar]
  25. Zajdela A., Ghossein N. A., Pilleron J. P., Ennuyer A. The value of aspiration cytology in the diagnosis of breast cancer: experience at the Fondation Curie. Cancer. 1975 Feb;35(2):499–506. doi: 10.1002/1097-0142(197502)35:2<499::aid-cncr2820350231>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES