Diagnostic Performance of Ultrasound-Guided Fine-Needle Aspiration of Nonpalpable Breast Lesions in a Multidisciplinary Setting: The Institut Curie's Experience. Issue 6 (13th May 2017)

• Record Type: Journal Article
• Authors: Farras Roca, Josep A.; Tardivon, Anne; Thibault, Fabienne; El Khoury, Carl; Alran, Séverine; Fourchotte, Virginie; Marck, Véronique; Alépée, Bernard; Sigal, Birigitte; de Rycke, Yann; Rouzier, Roman; Klijanienko, Jerzy
• Is Part Of: American journal of clinical pathology. Volume 147:Issue 6(2017)
• Page Start: 571
• Page End: 579
• Publication Date: 2017-05-13
• Subjects: Breast -- Fine-needle aspiration -- Diagnostic performance -- Ultrasound guided -- Nonpalpable; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqx009
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: To assess the diagnostic performance of ultrasound-guided fine-needle aspiration (USFNA) in nonpalpable breast lesions (NPBLs) in a multidisciplinary setting. Methods: In total, 2, 601 NPBLs underwent USFNA by a radiologist-pathologist team. Gold-standard diagnosis was based on surgery, core-needle biopsy, or 1-year imaging follow-up. USFNA's diagnostic performance was analyzed in different clinical and imaging subgroups. Results: USFNA's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were, respectively, 92.6% (95% confidence interval [CI], 90.8%-94.2%), 96.8% (95% CI, 95.8%-97.6%), 94.8% (95% CI, 93.2%-96.1%), and 95.4% (95% CI, 94.3%-96.4%). The best PPV was achieved in Breast-Imaging Reporting and Data System (BI-RADS) categories 4C and 5 and the best NPV in BI-RADS categories 2, 3, and 4A and in patients younger than 50 years. The mitotic count, BI-RADS categories, associated palpable cancer, and age (<50 or ≥50 years) were statistically independent factors ( P < .05) between USFNA's false-negative and true-positive results. Conclusions: USFNA is a robust diagnostic procedure in NPBLs. Age and the BI-RADS category of the lesion are important factors determining its performance.