CARDIFF, Wales--Breast imaging studies can proceed immediately
after fine-needle aspiration (FNA) cytology without concern that
the biopsy procedure will distort tissue architecture and compromise
diagnostic accuracy, said Neil Fenn, MD, a breast disease specialist
at the University of Wales.
In his study, only five of 168 women had tissue distortion on
mammography performed after FNA, and only two of the five had
breast imaging within 10 days of the biopsy. The findings strongly
suggest that delaying mammography to avoid problems with distortion
is unwarranted, he said.
The diagnostic accuracy of mammog-raphy performed after FNA came
into question more than a decade ago, he said, citing a Radiology
article (145:44, 1982).
The concern centered on the possibility that breast tissue distortion
and hema-toma formation might cause benign lesions to appear malignant
on mammog-raphy, leading to false diagnoses and unnecessary surgeries.
A 10-day delay between FNA and imaging has been suggested (Am
J Surg 145:395, 1983).
"In the evolving era of rapid diagnostic service, it's not
always possible to perform imaging prior to FNA cytology,"
Dr. Fenn said. "Delaying breast imaging may unnecessarily
heighten the anxiety of a woman who already is anxious about the
discovery of a lesion in her breast."
To reduce unnecessary waiting during this stressful period, the
Welsh physicians perform imaging at the next available appointment
in the department of radiology, regardless of the time of fine-needle
aspiration, he said.