Breast Cancer Research and Treatment

, Volume 158, Issue 2, pp 297–305 | Cite as

Breast fine needle aspiration continues to be relevant in a large academic medical center: experience from Massachusetts General Hospital

  • Jianyu Dong
  • Amy Ly
  • Ronald Arpin
  • Quratulain Ahmed
  • Elena Brachtel
Preclinical study


Fine needle aspiration (FNA) is increasingly being supplanted by core needle biopsy. However, breast surgeons continue to rely on FNA at our institution. This retrospective study evaluated breast FNA for its diagnostic accuracy and breast cancer biomarker testing utility. All breast FNAs performed at Massachusetts General Hospital 2009–2015 were reviewed. Cytology diagnoses were compared with subsequent tissue or clinical diagnoses. Immunohistochemistry and fluorescence in situ hybridization (FISH) results using formalin-fixed paraffin-embedded (FFPE) cell blocks and histologic tissue blocks were compared. 1654 consecutive breast FNAs were included. Breast FNA demonstrated the following diagnostic performance: positive predictive value of malignant cytology diagnosis 100 %, negative predictive value of benign cytology diagnosis 97.5 %, complete sensitivity 91.6 %, and specificity 95.5 %. Concordance rates for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) immunohistochemistry, and HER2 FISH were 98.2 % (κ = 0.95, p < 0.001), 100.0 % (κ = 1.000, p < 0.001), 83.1 % (κ = 0.69, p < 0.001), and 93.5 % (κ = 0.785, p < 0.001), respectively. Review of consecutive breast FNAs in a large cohort confirmed the excellent accuracy of this biopsy technique for breast lesion diagnosis. FNA FFPE cell blocks collected in the course of routine clinical care are adequate, practical, and reliable for breast cancer biomarker testing.


Breast Fine needle aspiration Diagnostic accuracy Cell block Fluorescence in situ hybridization 



Departmental support.

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical standards

This study complies with current laws of the United States.

Research involved in human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

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Supplementary material 3 (DOC 37 kb)
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Supplementary material 4 (DOC 38 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Jianyu Dong
    • 1
    • 2
  • Amy Ly
    • 1
  • Ronald Arpin
    • 1
  • Quratulain Ahmed
    • 3
  • Elena Brachtel
    • 1
  1. 1.Department of Pathology, Division of CytologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Breast CenterNanfang Hospital, Southern Medical UniversityGuangzhouChina
  3. 3.St. John Providence Health SystemSouthfieldUSA

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