Clinical, radiological and cytological diagnosis of breast cancer in young women.

In women over the age of 35 years, an accurate diagnosis of breast cancer can be made in over 95 per cent of patients using a 'triple assessment' system collating information from clinical examination, mammography, sonomammography, and fine-needle aspiration cytology. These methods have not been specifically evaluated in women aged 35 years or less, hence a study was undertaken on 30 such patients. Clinical examination was unreliable in predicting malignancy with a sensitivity of only 37 per cent. Thirty per cent of patients presented with a lump which had the clinical features of a fibroadenoma. Radiological methods were less sensitive in detecting malignancy in this age group than in older patients. The sensitivity of aspiration cytology was 78 per cent which was higher than that for breast cancer at all ages. Histology showed that there were fewer low grade tumours and fewer scirrhous tumours in this age group than in a control group of women aged over 35 years. This study indicates that cytological confirmation of apparently benign focal breast lesions in young women is essential, especially when these are managed conservatively.