Computer-designed expert systems for breast cytology diagnosis.

Three expert systems have been developed to diagnose from nine scalar values visually assigned to epithelial cells obtained by breast fine needle aspiration. These expert systems achieved up to 0.98 sensitivity and 0.97 specificity. When applied to 804 breast masses, the clinical sensitivity was 0.98 and specificity was 0.93 (exclusive of the 0.04 unsatisfactory aspirates). Cancers can be missed physically during the aspiration process; thus, some clinically suspicious masses were biopsied despite benign cytology. This contributed to the difference between the expert system and clinical specificities.