Breast citology

Fine needle aspiration (FNA) has traditionally been regarded as the simplest, less invasive and less expensive diagnostic procedure for the definition of breast lesions. In expert hands, it allows obtaining an accurate diagnosis in most breast lesions. The introduction of widespread mammographic screeningprogrammes and the consequent detection of a large number of small, non-palpable lesions have increasingly brought to the routine use of other minimally invasive biopsy methods using heavier gauge cutting needles – the so-called core biopsies (CB) and other automatic, imaging-guideddevices, such as vacuum assisted biopsies (VAB) – partially obscuring the central role of FNA. Recently, new recommendations propose to definitively abandon FNA, restricting all morphological investigations to CB.Has FNA completely lost its role as to let us to remove it from the routine diagnostic practice? In our personal experience from the breast unit of Trieste, where there systematic use of FNA is available, it is proved that this method may bring to a definitive diagnosis 2/3 of the lesions investigated. The unjustified abandonment of the technique by breast healthcare centres must be avoided, since it could only have negative repercussions on the whole preoperative diagnostics.it is necessary for the pathologists to guarantee the maintenance of their professional expertise in this field, and to transmit it to the young.