[397] Fine Needle Aspiration Biopsy of Palpable Breast Masses Is Associated with Shorter Length of Time to First Treatment Compared with Core Biopsy

Amy Ly, Jill Ono, Kevin Hughes, Martha B Pitman, Ronald Balassanian. Brigham and Women's Hospital, Boston, MA; Massachusetts General Hospital, Boston, MA; University of California, San Francisco, CA

Background: Time to treatment has been shown to be an important measure of quality in cancer care. Fine Needle Aspiration Biopsy (FNAB) for the evaluation of breast lesions remains underutilized and has been supplanted by core biopsy (CB) in many centers. We compared time to treatment in two matched patient cohorts with palpable breast masses diagnosed by either FNAB or CB.
Design: We reviewed medical records of all patients who received FNAB or CB in 2009 for palpable breast masses at two affiliated tertiary academic medical centers. One center utilized a pathologist-run FNAB clinic and the other utilized CB almost exclusively. Data retrieved from the common lab information system included age, lesion size (by palpation for FNAB, by imaging for CB), diagnosis, and time from presentation to excision or neoadjuvant therapy (NEO).
Results: Of 257 total FNAB, 51 went to excision and 3 received NEO (mean age 52; range 19-92). Of 1346 total CB, 103 were excised and 15 were treated with NEO (mean age 52; range 18-87). At time of biopsy, median breast mass size for FNAB was 1.5 cm (range 0.4-7.0) and for CB was 1.7 cm (range 0.3-6.0). Median carcinoma size for FNAB was 1.8 cm (mean 2.09, range 0.9-3.1) and for CB was 2.1 cm (mean 2.35, range 0.4-8.0). Median time from presentation to excision or NEO was shorter for FNAB patients.

Length of Time to Treatment (days)

	All Patients	All Patients	All Patients	Benign Lesions	Benign Lesions	Benign Lesions
	Mean	Median	Range	Mean	Median	Range
FNAB	67.02	38.5	2-294	108.5	87.5	9.0-294
CB	58.44	44	9-402	175.17	155.0	56-402

Length of Time to Treatment (days)

	Indeterminate Lesions	Indeterminate Lesions	Indeterminate Lesions	Malignant Lesions	Malignant Lesions	Malignant Lesions
	Mean	Median	Range	Mean	Median	Range
FNAB	69.8	44	11-288	34.16	32.0	2.0-66
CB	59.81	51.0	20-180	49.61	41.0	9.0-239

Conclusions: Patient age and lesion size were similar for FNAB and CB cohorts at time of biopsy. Median size of carcinoma at excision was slightly smaller for FNAB cases. Median length of time from presentation to first treatment was shorter for patients diagnosed by FNAB compared with CB in all diagnostic categories. These findings suggest FNAB is advantageous for faster triage of breast patients to treatment. Careful selection of patients with palpable breast lesions appropriate for FNAB evaluation may improve patient care.
Category: Cytopathology

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 80, Tuesday Morning