Fine needle aspiration or core biopsy

The literature on fine needle aspiration cytology (FNAC) and core biopsy (CB) has been reviewed. The published results to date reveal better overall results for CB than FNAC. This is likely to be largely due to easier collection, preparation and pathological interpretation of specimens. FNAC, however, has distinct advantages in terms of potential speed of preparation and reporting, the sampling of palpable lesions without image guidance and ultrasound guided biopsy of small lesions. Where good quality FNAC and CB are available, both should be used in combination, the use of FNAC or CB being tailored to the logistics of the clinic and the nature of the lesion. Repeated audit of performance of all aspects of needle biopsy is vital and multidisciplinary teamwork essential for safe interpretation and patient management. A large number of research projects, often by leaders in their field, achieve results under conditions which may be very different from those obtained on a large scale in differing centres. Such data have been collected from the UK breast screening centres and are presented in an accompanying article.1a