Cyto-radiological disageement: management

In Trieste, pathologists have been actively involved in breast diagnostics working alongside radiologists in the sampling time in order to set up together the most adequate approach in case-solving basing on the clinical/radiological and rapid stain cytological findings. Based on our own experience we prefer, whenever possible, to use the fine needle aspiration sampling method (FNA), almost always under ultrasound guidance, even for palpable lesions, reserving tru-cut biopsy only for a limited number of cases and vacuum-assisted biopsy (VAB) only in not ultrasound detectable lesions (id: isolated microcalcifications). The collaboration between radiologist and pathologist is essential to correctly evaluate identified lesions: the more coincident the results of radiological and cytological exams are, the more accurate the final diagnosis will be. Nevertheless there are some cases in which radiology and cytology do not agree. We decided to reassess the entire database, focusing on the management of discrepant cases in the light of the final histological diagnosis for surgical-treated cases or referring to the follow-up exams in the cases that did not undergo surgery.