• Breast pathology

Our recent review1 on a cohort of fine needle aspiration of the breast reported an atypical rate of about 7%, and of these, about 2% had a histological follow-up. A further analysis was carried out on these cases with excision, yielding a benign rate of about 67%. Cases without histological excision were excluded from the calculation, as a significant number of cases were lost to follow-up, and while a proportion may not have been subjected to surgery because of radiological benignity, we cannot assume that these represent the majority. This figure was actually in concordance with that reported in the literature that ranges from 48% to 68%.2–5 Nevertheless, we concede that our reported benign rate of 67% taking into account only those with histological excision will represent a lower end of the range of benign outcomes of atypical aspirates.

The aim of our review was to evaluate cytological parameters predictive of excision outcome in a cohort of atypical aspirates. We did not set out to assess the accuracy of how an atypical diagnosis was made in cytology, and hence did not reclassify these atypical FNACs in this cohort. We agree that reclassification of specific criteria for diagnosis of atypia in breast aspirates will be a worthwhile exercise in further understanding and promoting precision in this category.