Fine Needle Biopsy Requires Trained Doctor

A study has found that doctors who had no formal training in performing a fine needle aspiration biopsy (FNAB) missed 25% of breast cancers at three U.S. hospitals, while formally trained doctors there missed only 2% of cancers. The study, conducted by researchers from the University of California, San Francisco (UCSF, USA) was published in the August 25, 2001, issue of Cancer Cytopathology.

To determine that a cancer was missed, the researchers closely followed the medical histories of 927 women for a minimum of two years. They found that less-well-trained doctors were more likely to send samples to the lab that contained the wrong cells because of their poor sampling technique. The formally trained doctors had completed fellowship training in cytopathology or the equivalent and had performed at least 150 FNABs under supervision. The researchers note that FNAB is fast, inexpensive, and less likely to cause side effects like bleeding than more invasive methods but requires sampling accuracy.

The difference between the trained and untrained doctors was entirely due to errors in sampling the lesion rather than in interpreting the specimen, said the researchers. "The only factor that made a difference in the rate of accurate diagnosis was the training of the practitioner,” said Britt-Marie Ljung, M.D., lead author of the study.





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