To the Editor.—The complexities of diagnosing small breast cancers plague all of us. A single diagnostic technique, fine-needle aspiration (FNA), was described by Adye et al1 in the January issue of the Archives. I express reservations about their study of this technique.
1. Size of the mass. Is FNA really appropriate for lesions that have no mammographic density and are only a cluster of calcifications?
The authors stated that the operator "stabilizes the mass," but this is impossible for many occult lesions. The authors also describe the smallest lesion detected in their study as being 1×0.8×0.6 cm, which would exclude many of the tiny lesions we are desirous of detecting and diagnosing. It would be helpful to know how many patients had their conditions diagnosed by other techniques, ie, how the practical selection of the 137 patients in the study was accomplished.
The authors excluded "a few patients"
MOORE GE. Breast Cancer Diagnosis. Arch Surg. 1988;123(8):1024. doi:10.1001/archsurg.1988.01400320110026