Is clinical information important when interpreting breast fine needle aspirates?

Comparison was made between 2 years when breast fine needle aspirates (BrFNAs) were reported oblivious of clinical information (no details) and 2 years where relevant information (details) was incorporated into the diagnostic process to assess the influence on interpretation. Performance year on year was compared. Receiver operating characteristic (ROC) curve analysis was used to assess change in specificity and sensitivity. Likelihood ratios, being the most meaningful clinical measure, were established for each diagnostic group. An average of 770 fine needle aspirates were reported each year. Fewer false positive cases were reported with details and better absolute sensitivity (66.0% vs 62.0%) and complete specificity (63.9% vs 56.2%) were achieved. This was above that expected by increasing experience, i.e. comparing year 1 and 2 but the difference failed to reach statistical significance. ROC curves were virtually unchanged. There is a difficulty in ascertaining if improved performance is significant; however, the change supports the accepted need for clinical details when reporting BrFNAs.