Fine needle aspiration versus core needle biopsy in the diagnosis of the intraductal breast papillary lesions
Yoko Omi, Tomoko Yamamoto, Takahiro Okamoto, Toshio Nishikawa and Noriyuki Shibata
World Journal of Pathology 2013, 2:11
Diagnosing breast intraductal papillary lesions by fine needle aspiration (FNA) is often difficult and provides indeterminate results. The aim of this study was to determine an effective diagnostic method for intraductal papillary lesions, when the initial FNA cytology was insufficient.
Patients and Methods
The cytopathology records of 79 women diagnosed with intraductal papillary lesions were retrospectively evaluated
Of the initial FNAs, 26 specimens were classified as benign, 51 were indeterminate, and 2 were suspicious for malignancy. Repeat FNAs or core needle biopsies (CNBs) were performed on 20 and 23 cases, respectively. Thirteen of 20 cases (65%) of the second FNA specimens and 6 of 23 cases (26%) of the CNBs were indeterminate. The probability of indeterminate diagnosis was significantly lower in the CNBs than the second FNAs (p<0.05). However, some cases failed to be diagnosed by CNB, partly because the samples were insufficient for diagnosis, and partly because the lesions seemed to be beyond the diagnostic capability of CNB even with an aide of immunohistochemistry using multiple primary antibodies. Overall, 13 of 79 cases were malignant. /p>
For intraductal papillary lesions initially diagnosed using FNA, a CNB may be recommended instead of FNA, if additional evaluation is required. An adequate CNB may facilitate accurate diagnosis, although some cases will remain indeterminate.
Intraductal papillary lesion, Fine needle aspiration, Core needle biopsy