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March 20, 1987

Needle Aspiration Biopsy of the Breast

JAMA. 1987;257(11):1470. doi:10.1001/jama.1987.03390110046010

To the Editor.—  I am surprised to find myself, in 1987, having to defend fine needle aspiration biopsy of the breast, an established procedure labeled "unnecessary" by Dr Flamm in his letter to the editor published in your Jan 16,1987, issue.1Dr Flamm states that "there is considerable debate as to the accuracy of this procedure." Debate among whom? Provided that rigid and tested cyto-pathologic criteria for diagnosing cancer2 are adhered to, this test is no less reliable than any other cytological sampling procedure. Of course, it goes without saying that a negative or inconclusive aspiration biopsy result in the face of suspicious mammographic findings or a palpable mass should always be followed by further investigation, including open biopsy.In response to Dr Flamm's question, "of what value is this procedure?," I wish to point out the following advantages of a positive diagnosis on fine needle aspiration biopsy: