The use of fine-needle aspiration cytology and core biopsy in the assessment of highly suspicious mammographic microcalcifications: analysis of outcome for 182 lesions detected in the setting of a population-based XXXX screening program.

@entity1 @entity0 @entity5 @entity2286 @entity400
BACKGROUND: @entity400 ( @entity400 ) is used as the first-line diagnostic test for lesions that require morphologic assessment in the authors' @entity0 screening program. A positive cytologic diagnosis is an indication to proceed to definitive surgery. Core biopsy is used if @entity400 is not diagnostic. In the context of increased use of core biopsy at other centers, the authors reviewed their experience with the cytologic assessment of highly suspicious microcalcifications. METHODS: Between January 1996 and June 2000, the dominant radiologic abnormality was classified prospectively as high-grade microcalcifications in 182 lesions. Data were recorded on @entity1 demographics, radiologic features, and the findings of @entity400 and core biopsy, if performed. The results of the screening assessment were then compared with the final histologic findings. RESULTS: Overall, 15.6% of all radiologically high-grade lesions were microcalcifications. The mean @entity1 age was 58.76 years. The lesions had a mean size of 38.49 mm (range, 5-200 mm), and 92.31% of high-grade microcalcifications proved to be malignant. Among the cases evaluated by @entity400 , a positive cytologic diagnosis of @entity5 was made in 70.93% of lesions, without any false-positive diagnoses and obviating the need for diagnostic core biopsy. @entity400 had a sensitivity of 77.22% and a positive predictive value ( @entity2286 ) of 100%. When core biopsy was performed due to the absence of a positive cytologic diagnosis, it averted the need for open biopsy in 76% of lesions. CONCLUSIONS: Where there is access to skilled cytopathologists, @entity400 can provide a highly accurate, rapid, and cost-effective means of triage of @entity1 who would benefit most from the more expensive core biopsy.
