The role of fine needle aspiration cytology in the management of solid breast tumors.

The value of fine needle aspiration cytology in patients with breast masses has found limited acceptance in the United States. When employed consistently, however, it has been reliable and has facilitated patient management. A positive cytological diagnosis of cancer has always been confirmed by histology, while "atypical," "suspicious," and "abnormal" categories represent cancer in varying degrees of frequency and open biopsy is usually necessary. The method is quick, easy, and causes no morbidity. The critical aspects for its success are those of interested surgeons and cytopathologists, and appropriate sampling and processing technique. In our experience with fine needle aspiration cytology in 38 patients with breast tumors, all 23 patients with cytological diagnosis of cancer, three of four with suspicious, and one of three with atypical smears proved to have cancer. Two of four patients with unsatisfactory smears had carcinoma on biopsy, both of the infiltrating lobular variety. Based on this limited experience, as well as on information in the available literature, fine needle aspiration cytology is strongly recommended in the evaluation and management of patients with breast tumors.