Usefulness of Core Needle Biopsy Compared with Fine Needle Aspiration Cytology for Palpable Breast Masses

Youn, Hyun Jo; Jung, Sung Hoo

Abstract

PURPOSE: Fine needle aspiration cytology (FNAC) is an established, highly accurate method for diagnosing breast lesions. However, core needle biopsy (CNB) is being increasingly used in this setting. The purpose of this study was to evaluate the accuracy of both methods and to assess which is more proper as an initial diagnostic method for palpable breast masses.
METHODS
The authors performed 403 FNACs and 226 CNBs in palpable breast masses between January 2002 and December 2002. The cytologic diagnoses were classified into three groups: malignant, suspicious or benign, and the histologic diagnoses were classified into three groups: malignant, atypical or benign. Histological conformation was obtained in 123 aspirated cases and 69 biopsied cases, either by open biopsy or mastectomy.
RESULTS
FNAC and CNB did equally well for the specificity (98.4% vs 100%), the false positive rate (1.6% vs 0%), and the positive predictive value (97.4% vs 100%) for malignancy. However, statistical differences are found for the sensitivity (63.8% vs 92.5%; P=0.000), the false negative rate (36.2% vs 7.5%; P=0.000), and the diagnostic accuracy (81.8% vs 92.4%; P=0.006).
CONCLUSION
For palpable breast masses, CNB has a higher sensitivity, diagnostic accuracy and lower false negative rate than FNAC. Our study suggests that CNB is a useful initial diagnostic tool for assessing a breast mass before establishing a treatment strategy.