โ Scribed by V. K. Kapoor; T. K. Chattopadhyaya; L. K. Sharma; J. Bradbeer
No coin nor oath required. For personal study only.
We were surprised to read the article by Mr Bradbeer recommending Tru-cut needle biopsy for out-patient diagnosis of breast cancer (Br J Surg 1985; 7 2 927-8). Fine needle aspiration cytology (FNAC) is easy, cheap, safe and equally (if not more) effective. FNAC, unlike Tru-cut needle biopsy, needs no assistance; no local anaesthesia is required as no skin incision is made. FNAC causes minor bruising only whereas Trucut needle biopsy can cause marked bruising and haematomas'. In 328 patients 99 per cent sensitivity and 95 per cent specificity has been reported'. Wollenberg et aL2 have reported 91.3 per cent overall diagnostic accuracy with FNAC, the predictive values of positive and negative diagnosis being 100 per cent and 89.6 per cent respectively. FNAC ensures collection of cellular material from throughout the mass owing to simultaneous in-and-out and radiating motion of the needle providing a fan-like sampling pattern3. Most of the false-negatives are due to sampling errors and false-positives occur only during the learning phase. Experienced and interested cytotechnologists and cytopathologists can lower the incidence of false-negatives and eliminate false-positives altogether. False-positives are, on the other hand, seen even with Trucut biopsy4 and frozen section biopsy5. FNAC should therefore be the initial diagnostic procedure for a breast lump.
๐ SIMILAR VOLUMES
The risk of complications from percutaneous liver biopsy is low, but discomfort is common and complications require hospitalization in approximately 4% of patients. The optimal method of performing these biopsies is unknown. The goal of our study was to determine whether the use of ultrasonography i