The fine needle aspiration biopsy diagnostic criteria of proliferative breast lesions: a retrospective statistical analysis of criteria for papillomas and radial scar lesions.

This study aimed to analyze statistically the accuracy of fine needle aspiration biopsy cytological criteria in diagnosing epithelial hyperplasia with atypia (EHA), papillary lesions (PAP), and radial scar/complex sclerosing lesions (RS/CSL). The 42 criteria studied were extracted from a literature review and those developed and used in our department. Cytological cases with diagnoses of EHA, PAP, and RS/CSL for the period of 1997-2001 were correlated with relevant histological follow-up and the positive predictive power of these diagnoses have been presented in an earlier publication. Some 77 cases with definite, specific histological diagnoses of atypia or a more severe lesion, PAP and RS/CSL, were reviewed and scored using 55 cytological criteria. As the group of EHA and RS/CSL yielded a smaller number of cases, these were grouped together in the statistical analysis and compared to PAP. The cytological features, which were most diagnostic for PAP, were stellate (Odds ratio 1.75) and meshwork (Odds ratio 3.29) tissue fragments, while the presence of tubular structures was inversely proportional to the histological outcome of PAP. True papillary fragments were uncommon and not statistically significant in diagnosing PAP of the breast.