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.