Diagnostic Performance of Ultrasound-Guided Fine-Needle Aspiration ofNonpalpable Breast Lesions in aMultidisciplinary Setting: The InstitutCurie's Experience

Abstract

Objectives: To assess the diagnostic performance of ultrasound-guided fine-needle aspiration (USFNA) in nonpalpable breastlesions (NPBLs) in a multidisciplinary setting. Methods: In total, 2,601 NPBLs underwent USFNA by aradiologist-pathologist team. Gold-standard diagnosis wasbased on surgery, core-needle biopsy, or 1-year imaging follow-up. USFNA's diagnostic performance was analyzed in differentclinical and imaging subgroups. Results: USFNA's sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) were, respectively,92.6% (95% confidence interval [CI], 90.8%-94.2%), 96.8%(95% CI, 95.8%-97.6%), 94.8% (95% CI, 93.2%-96.1%), and95.4% (95% CI, 94.3%-96.4%). The best PPV was achieved inBreast-Imaging Reporting and Data System (BI-RADS)categories 4C and 5 and the best NPV in BI-RADS categories 2, 3,and 4A and in patients younger than 50 years. The mitoticcount, BI-RADS categories, associated palpable cancer, and age(<50 or ≥50 years) were statistically independent factors (P < .05) between USFNA's false-negative and true-positiveresults.Conclusions: USFNA is a robust diagnostic procedure in NPBLs.Age and the BI-RADS category of the lesion are importantfactors determining its performance.