Wells C A, Perera R, White F E, Domizio P
Department of Pathology, St Bartholomew's Hospital, London, UK.
Breast. 1999 Oct;8(5):261-6. doi: 10.1054/brst.1999.0068.
The National Breast Screening Service in the UK depends upon triple assessment, with or without core biopsy, to determine the need for diagnostic biopsy or treatment for screen-detected lesions. To determine the efficacy of cytology in this process a nationwide survey of sensitivity and specificity of the technique was instituted by the National Coordinating Committees for both Radiology and Pathology. Although some units were performing to the national recommended standards, a significant number of units were shown to have problems with a high false negative rate and high inadequate rates from lesions which were eventually diagnosed as cancer. This suggests problems in localizing lesions adequately at aspiration. Generally, indicators of pathology diagnostic performance (e.g. positive predictive values) were good. The figures suggest that some units are not benefiting from an optimal cytological service. Consequently training programmes targeted at aspiration technique may be beneficial.
英国国家乳腺筛查服务依靠三重评估（无论有无核心活检）来确定对筛查发现的病变进行诊断性活检或治疗的必要性。为了确定细胞学在这一过程中的有效性，放射学和病理学国家协调委员会开展了一项关于该技术敏感性和特异性的全国性调查。尽管一些单位的表现达到了国家推荐标准，但大量单位被证明存在问题，即假阴性率高，以及最终被诊断为癌症的病变的取材不足率高。这表明在穿刺时对病变进行充分定位存在问题。总体而言，病理学诊断性能指标（如阳性预测值）良好。这些数据表明，一些单位没有从最佳的细胞学服务中受益。因此，针对穿刺技术的培训项目可能会有所帮助。
