Conclusion

Core biopsy and FNA are effective methods for the diagnosis of screen-detected breast lesions. Whilst FNA may offer rapid assessment and is a relatively non-invasive technique, it is less sensitive in comparison to core biopsy and requires specific expertise which is likely to diminish with the reduced use of FNA within the BreastScreen Australia program. Moreover, core biopsies are more suitable for the definitive assessment of borderline and in situ lesions, as well as prognostic features and receptor assessment in invasive lesions which is important to guide treatment decisions. FNA may be used under limited circumstances such as for the investigation of cysts or where a core biopsy may not be possible, particularly where rapid on-site reporting is available. In the BreastScreen Australia program, a limited number of services have access to rapid on-site reporting. For the investigation of the majority of screen-detected lesions in the context of the BreastScreen Australia program, core biopsy under image guidance is a sensitive and specific technique and is the procedure of choice for the assessment of the majority of screen-detected breast lesions.