Core biopsy vs fine needle aspiration cytology in a symptomatic breast clinic

Aim: The adequacy of physical examination, mammography and fine needle aspiration cytology (FNAC) (conventional triple assessment) in the diagnosis of breast cancer has been questioned. We have performed a prospective study directly comparing FNAC and core biopsy in our symptomatic breast clinic. Method: Between 15/5/00 and 17/1/01, 330 consecutive patients with breast lumps were assessed by physical examination, ultrasound, and mammography if over 35 years, and FNAC and core biopsy with or without ultrasound guidance. Results: Three hundred and forty four specimens yielded the following FNAC and core biopsy results: C1-109, C2-144, C3-6, C4-17, C5-68; B1-97, B2-150, B3-7, B4-3, B5-87. The FNAC results corresponding to the 87 B5 samples were as follows: C1-5, C2-2, C3-0, C4-12, C5-68. All C5 samples were associated with a corresponding B5 result. All except one cancer in this series was diagnosed at a single clinic visit. Conclusion: In this series, core biopsy diagnosed symptomatic breast cancer more accurately than FNAC.