Study: Physician Training Key to Accuracy of Needle Aspiration

When a well-trained physician performs a fine needle aspiration of the breast, the diagnostic procedure is highly accurate and cost-effective and could replace a large number of surgical biopsies, according to researchers at the University of California, San Francisco and the University of Vermont.

However, when inadequately trained physicians perform fine needle aspiration of the breast, the procedure may be misleading and potentially harmful, according to a study published in Cancer Cytopathology.

Researchers designed a study to examine the effects of training doctors in the sampling technique of fine needle aspirations from palpable breast masses.

Aspirations were performed by 729 formally trained doctors who had previously performed 150 aspirations under supervision and another 100 during the year. Doctors who had received no formal training and had performed an average of only 2 aspirations during the year aspirated 314 specimens.

Specimens were evaluated for cellularity and type of material present to establish accuracy of diagnosis, and the rate of surgical intervention. All cases were matched with the Northern California Cancer Registry and followed up for 2 years. Aspiration specimens were correlated with histologic specimens when they were available.

The formally trained doctors missed 2 percent of malignancies compared with 25 percent missed by the untrained physicians, reported the researchers.

Other Sources: Cancer Cytopathology