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July 1989

Fine-Needle Aspiration for Breast Mass Diagnosis

Author Affiliations

From the Departments of Surgery (Dr Wolberg), Human Oncology (Drs Wolberg and Tanner), and Statistics (Drs Tanner and Loh), University of Wisconsin, Madison.

Arch Surg. 1989;124(7):814-818. doi:10.1001/archsurg.1989.01410070068014

• Our accuracy in diagnosing 464 solid breast masses by fine-needle aspiration was enhanced by a statistically based algorithm for distinguishing between benign and malignant epithelial cells. Epithelial cells were obtained from 378 breast masses by fine-needle aspiration; nonepithelial cells considered diagnostic of benign conditions were obtained from 66 breast masses, and 19 aspirations were considered unsatisfactory. Excluding one benign cystosarcoma, the algorithm gave 3 false-negative diagnoses and 16 false-positive diagnoses with 211 benign and 167 malignant samples. The overall clinical performance measures for the 444 masses from which diagnostic fine-needle aspirations were obtained and excluding the cystosarcoma were 0.98 sensitivity, 0.94 specificity, and 0.92 positive predictability. Masses diagnosed as benign by fine-needle aspiration can be followed up clinically. Intraoperative frozen section is needed before definitive surgery to determine invasion and confirm the diagnosis of some cytologically malignant masses.

(Arch Surg. 1989;124:814-818)

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