Stereotaxic Fine Needle Aspiration of Nonpalpable Breast Lesions with the Cytoguide Unit: First Experiences

Abstract

At present, the highest efficiency obtained in diagnosis of clinically occult breast lesions, for example, carcinomas less than or equal to 10 mm in diameter or findings of prospective significance, is only achieved with mammography. In the recent literature, Holland et al. (1983), among others, have pointed out the particular significance of microcalcifications appearing in preliminary mammo- graphs of clinically asymptomatic women. There are limitations, however, in obtaining a clear, unequivocal, definitive statement. This applies to cases where dense fibrocystic masses restrict mammographic diagnostic possibilities or in cases where mammographically suspect lesions do not demonstrate any clear criteria of malignancy. Correct detection of malignancy in these abnormal lesions, with few exceptions, is approximately 20% (Moskowitz 1983). This means that up to 80% of the cases recommended for biopsy in the case of mammographically suspicious lesions are histologically benign. This brings about a significant physical, emotional, and economic disincentive for women to participate in annual screenings. It is therefore recommended that nonpalpable breast lesions be initially investigated using a less invasive diagnostic procedure than that of open biopsy.