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Original ArticleOpen Access
Role of Combined Fine Needle Aspiration and Ultrasonography in the Diagnosis of Impalpable Lesions of the Breast
Sampatanukul P 
,
Boonjunwetwat D ,
Pakart P
,
Boonjunwetwat D ,
Pakart P PICHET SAMPATANUKUL, MD, MSc*,
DARUNEE BOONJUNWETWAT, MD**,
PATCHARAJIREE PAK-ART, MD**
Objective: To evaluate the efficacy of combined fine needle aspiration (FNA) and ultrasono-
graphy in the diagnosis of impalpable breast lesions.
Method :To analyze the diagnostic performance of the FNA cytology and ultrasound among
female patients with impalpable breast lesions that were referred to the FNA clinic at King Chula-
longkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand
during the period of July 2001 to June 2002. The final diagnoses employed surgical pathology and 6-
month follow-up of the patients.
Result : In a-year-period of the studied frame, there were 57 studied cases ( 18.3% of the total
FNA breast cases). To diagnose malignant lesions, FNA cytology achieved the sensitivity of 61 per cent
and the specificity of 100 per cent, whereas, diagnostic radiology had a sensitivity of 100 per cent and
specificity of 56.1 per cent. The FNA cytology was superior to ultrasound in the determination of
inflammatory lesions while imaging was dominant in the hard-to-aspirate malignant lesions. There-
fore, the combined cyto-radiology criteria could correctly diagnose malignancy in all cases (100%
accuracy).
Conclusion : The efficacy of combined FNA and ultrasonography in the diagnosis of impal-
pable breast lesions was highly satisfactory. The accuracy of each technique enhanced each other and
gave the correct diagnosis in all cases.
Key word : FNA, Impalpable, Nonpalpable, Breast Lesions, Ultrasound Guidance, ACR BI-RADS
DARUNEE BOONJUNWETWAT, MD**,
PATCHARAJIREE PAK-ART, MD**
Objective: To evaluate the efficacy of combined fine needle aspiration (FNA) and ultrasono-
graphy in the diagnosis of impalpable breast lesions.
Method :To analyze the diagnostic performance of the FNA cytology and ultrasound among
female patients with impalpable breast lesions that were referred to the FNA clinic at King Chula-
longkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University in Bangkok, Thailand
during the period of July 2001 to June 2002. The final diagnoses employed surgical pathology and 6-
month follow-up of the patients.
Result : In a-year-period of the studied frame, there were 57 studied cases ( 18.3% of the total
FNA breast cases). To diagnose malignant lesions, FNA cytology achieved the sensitivity of 61 per cent
and the specificity of 100 per cent, whereas, diagnostic radiology had a sensitivity of 100 per cent and
specificity of 56.1 per cent. The FNA cytology was superior to ultrasound in the determination of
inflammatory lesions while imaging was dominant in the hard-to-aspirate malignant lesions. There-
fore, the combined cyto-radiology criteria could correctly diagnose malignancy in all cases (100%
accuracy).
Conclusion : The efficacy of combined FNA and ultrasonography in the diagnosis of impal-
pable breast lesions was highly satisfactory. The accuracy of each technique enhanced each other and
gave the correct diagnosis in all cases.
Key word : FNA, Impalpable, Nonpalpable, Breast Lesions, Ultrasound Guidance, ACR BI-RADS
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