Department of Pathology, University Medical Center, Utrecht, The Netherlands.
J Clin Pathol. 2012 Apr;65(4):287-92. doi: 10.1136/jclinpath-2011-200410. Epub 2011 Oct 29.
Diagnosis of breast lesions is routinely performed by the triple assessment of a specialised surgeon, radiologist and pathologist. In this setting, fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) are the current methods of choice for pathological diagnosis, both with their specific advantages and limitations. Evidence-based literature discussing which of both modalities is preferable in breast lesion diagnosis is sparse and there is no consensus among different specialised breast cancer centres. This study reviews FNAC and CNB for diagnosing breast lesions, comparing methodological issues, diagnostic performance indices, possibilities for additional prognostic and predictive tests and cost effectiveness. Overall, CNB achieved better sensitivity and specificity especially in those lesions that were not definitively benign or malignant, non-palpable and/or calcified lesions. Although FNAC is easier to perform, interpretation requires vast experience and even then, it is more often inconclusive requiring additional CNB. The authors conclude that overall CNB is to be preferred as a diagnostic method.
乳腺病变的诊断通常由专业外科医生、放射科医生和病理学家进行三联评估。在这种情况下，细针抽吸细胞学（FNAC）和核心针活检（CNB）是目前病理诊断的首选方法，它们都有各自的优点和局限性。关于这两种方法在乳腺病变诊断中哪个更优的循证文献很少，不同的专业乳腺癌中心也没有共识。本研究回顾了 FNAC 和 CNB 在诊断乳腺病变中的应用，比较了方法学问题、诊断性能指标、进行额外预后和预测检测的可能性以及成本效益。总的来说，CNB 的敏感性和特异性更好，尤其是在那些不能明确诊断为良性或恶性、不可触及和/或钙化的病变中。虽然 FNAC 更容易操作，但需要丰富的经验才能进行解释，即使如此，FNAC 也更常出现不确定的结果，需要进一步进行 CNB。作者得出结论，总的来说，CNB 作为一种诊断方法更具优势。
