Mammographically guided fine-needle aspiration biopsy of nonpalpable breast lesions. Can it replace open biopsy?

The authors report the accuracy of mammographically guided fine-needle aspiration (FNA) for the diagnosis of nonpalpable breast lesions in a series of 71 patients. Each mammographically guided FNA was immediately followed by hookwire localization and open biopsy. Seven malignancies were identified cytologically, but three cancers were not detected in aspirates judged to be sufficient for diagnosis. In addition, 19 aspirates were reported to be insufficient, and 4 of these were obtained from lesions histologically proven to be adenocarcinoma. Although no false-positive diagnoses were encountered, the technique demonstrated a sensitivity of 78% and a diagnostic accuracy of 94% for adequate specimens. In this study, mammographically guided FNA was insufficiently sensitive to replace open biopsy for the diagnosis of nonpalpable breast lesions.