Objective: To examine the utility of palpation-guided fine-needle aspiration cytology (pgFNAC) in the context of clinically palpable but radiologically occult breast abnormalities in this era of digital mammography and high sensitivity ultrasound. Methods: Women undergoing pgFNAC from January 2005 to December 2007 were identified from the histopathology database and correlated with clinical and radiological findings recorded prospectively in electronic patient records. Results: 142 cases matching our selection criteria were identified with a mean age of 43 (SD ±13.7) years; 83 patients had focal lumps and 59 had non-focal lumpiness. In the latter, pgFNAC showed C1 cytology in 45 (76.3%), C2 in 13 (22%) and C3 in 1 (1.7%) patient. In 83 patients with a focal discrete lump, pgFNAC revealed C1 cytology in 65 (78.3%), C2 in 14 (16.9%), and 2 patients each had C3 and C4 cytology. Core biopsy was undertaken in the latter 4 patients, invasive cancer was found in 1 patient each with C3 and C4 cytology and benign pathology in the rest. To date, none of the patients discharged has developed pre-malignant or malignant lesions in the ipsilateral breast. Conclusion: In patients presenting with clinically palpable but radiologically occult breast abnormality, pgFNAC can identify those who need further investigation or who can be safely discharged.

National Institute of Clinical Excellence: Guidance on Cancer Services. Improving Outcomes in Breast Cancer. London, National Institute of Clinical Excellence, 2002, http://www.nice.org.uk/nicemedia/live/10887/28763/28763.pdf.
Morrow M: Physical examination of the breast; in Harris JR, Lippman ME, Morrow M, Hellman S (eds): Diseases of the Breast. Philadelphia, Lippincott Williams & Wilkins, 2004, pp 33–36.
NHSBSP: Guidelines for Pathology Reporting in Breast Disease. London, NHSBSP, 2005, http://www.cancerscreening.nhs.uk/breastscreen/publications/nhsbsp58.html.
Kerlikowske K, Smith-Bindman R, Ljung BM, Grady D: Evaluation of abnormal mammography results and palpable breast abnormalities. Ann Intern Med 2003;139:274–284.
Sterns EE: Age-related breast diagnosis. Can J Surg 1992;35:41–45.
Paramagul CP, Helvie MA, Adler DD: Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology 1995;195:231–234.
Evans WP, Warren Burhenne LJ, Laurie L, O’Shaughnessy KF, Castellino RA: Invasive lobular carcinoma of the breast: mammographic characteristics and computer-aided detection. Radiology 2002;225:182–189.
Selinko VL, Middleton LP, Dempsey PJ: Role of sonography in diagnosing and staging invasive lobular carcinoma. J Clin Ultrasound 2004;32:323–332.
Patel JJ, Gartell PC, Smallwood JA, Herbert A, Royle G, Buchanan R, et al: Fine needle aspiration cytology of breast masses: an evaluation of its accuracy and reasons for diagnostic failure. Ann R Coll Surg Engl 1987;69:156–159.
Morrow M, Wong S, Venta L: The evaluation of breast masses in women younger than forty years of age. Surgery 1998;124:634–640, discussion 40–41.
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