Background: Patients who are elderly or who have locally advanced breast cancer may initially receive primary medical therapy.
Methods: In order to avoid open biopsy in such patients, we routinely perform both fine needle aspiration cytology (FNAC) and core-biopsy at the first clinic visit.
Results: A retrospective review showed that of 109 such patients, 87 (80%) had the diagnosis confirmed on FNAC and 96 (88%) on core-biopsy. Only eight patients did not have a diagnostic result from the first clinic visit, and five of these patients were diagnosed on a repeat core-biopsy or FNAC. The remaining three patients had suspicious FNAC. Overall 97% had one or both investigations positive.
Conclusions: When considered alone core-biopsy was superior to FNAC. In this series the combined diagnostic approach of FNAC and core-biopsy has allowed outpatient diagnosis for virtually all patients.