Aspiration biopsy cytology for small breast cancer

To evaluate the diagnostic usefulness of aspiration biopsy cytology (ABC) in small breast cancers, we retrospectively studied 256 cases of breast cancer that underwemt preopera tive ABC. The overall diagnostic accuracy rate of ABC was 86.3%(221/256). ABC showed a high accuracy rate in diagnosis as compared with physical palpation, echogram, or mammogram, regardless of tumor size. The reason for the low rate of diagnostic accuracy in Tis (non-invasive cancer, 20%; 1/5) and T0 (non-palpable cancer, 0%; 0/2) cases was ascribed entirely to the lack of cancer cells in the specimens. In T1 (invasive cancer up to 2cm in diameter, 76.9%; 50/65) cases, the diagnostic accuracy of ABC was not influenced by the size of tumors, but by the histologic type. There was no significant difference in rate between the T1 subdivision every 5mm up to 2cm. On the other hand, the accuracy in T1 tumors varied from 84.2% in the solid tubular type and 95.0% in the scirrhous type to 57.9% in the papillotubular type and 57.1% in the special type. The low accuracy in the latter two tumor types may have been partly caused by the fact that there is difficulty in the palpation of the papillotubular type and a lack of understanding of the cytologic findings in the special type. In 11 cases of T1 tumor, the discovery of carcinoma was made only by ABC. Furthermore, some of the false negative cases were found to be retrospectively positive for carcinoma. Thus, we consider ABC to be a very useful diagnostic procedure for T1-sized small breast cancer.