Integrated Criteria of Fine-Needle Aspiration Cytology and Radiological Imaging for Verification of Breast Cancer in Nonpalpable Lesions
Pichet Sampatanukul MD, MSc*, Darunee Boonjunwetwat MD**, Voranuch Thanakit MD*, Patcharajiree Pak-art MD**
Affiliation : * Departments of Pathology, Faculty of Medicine, Chulalongkorn University ** Departments of Radiology, Faculty of Medicine, Chulalongkorn University
Objectives : To evaluate the accuracy of using radiologic, cytologic and integrated radiologic and cytologic
criteria in diagnosis of nonpalpable breast lesions.
Materials and Methods : From January 2003 to May 2004, a prospective study of performing fine-needle
aspiration biopsy (FNAB) was carried out at King Chulalongkorn Memorial Hospital on female patients with
nonpalpable or vaguely palpable lumps that needed ultrasound localization for the direction and depth.
Results : There were 162 lesions from 150 patients, consisting of 29 malignant neoplasms (17.9%) and 133
benign lesions (82.1%). Of the 107 classified as subcentimeter focal lesions (< 1 x 1 cm2 in size), two of
radiological malignancy were false and two others were falsely negative by cytology. While the 23 large/ill-
defined lesions (> 1.5 x 1.5 cm2 in size), one hiding malignant lesion adjacent to a prominent intraduct
papilloma was missed. Two others had falsely negative cytologic diagnosis. The integrated criteria achieved
accuracy and sensitivity of 97.5% and 93% compared with the cytology, 96.3% and 82.8% and the better
scenario of radiology, 95.7% and 82.8% respectively.
Conclusion : The integrated criteria provide the most accuracy rate and sensitivity rate for detection of
malignancy in nonpalpable breast lesions.
Keywords : FNA, Cytology, Breast, Imaging, Nonpalpable, Impalpable
