I n this issue of Cancer Cytopathology, Manfrin et al. 1 describe the quality performance results of fine-needle aspiration biopsies performed in their Breast Cancer Screening Program in Verona, Italy. Not surprisingly, because they have an integrated radiopathologic program with pathologists on the premises who perform real-time immediate assessments of fine-needle aspiration biopsies and are able to discuss these results with the radiologists, their results are very accurate.
Nearly 20 years ago, we created a multidisciplinary cytodiagnostic center that included onsite radiologists and pathologists. The radiologic aspect provided breast imaging services, which comprised mammograms, ultrasounds, and stereotactic fine-needle aspiration biopsies and core needle biopsies, and has since progressed to include digital mammograms, breast ultrasonography, breast magnetic resonance imaging (MRI) scans, ultrasound-guided fine-needle aspiration biopsies, ultrasound-guided core needle biopsies, stereotactic-guided core needle biopsies when necessary, and breast MRIguided core needle biopsies. The service includes fine-needle aspiration biopsies of all palpable masses (which are performed by the pathologist), mainly those of the breast, thyroid, lymph node, salivary gland, and soft tissue. All fine-needle aspiration biopsies, whether they are performed by the pathologist directly or by the radiologist under imaging guidance, are stained and assessed immediately and the majority of the time a diagnosis is rendered within approximately 10 minutes of the aspiration. The results are given to the patient or to their physician. For all diagnoses of breast cancer, there is a team comprised of radiologists, pathologists, oncologists, breast surgeons, plastic surgeons, radiation oncologists, social workers, genetic counselors, and research assistants that meet weekly to discuss prospective management planning.
At the beginning of our program, we performed approximately 800 fine-needle aspiration biopsies per year. In 2007, the Leslie Simon Cytodiagnosis and Breast Care Center evaluated 41,000 patients and performed 5300 fine-needle aspiration biopsies, of which approximately 3000 were fine-needle aspiration biopsies of See referenced original article on pages 74-82, this issue.