Background: Fine needle aspiration cytology (FNAC) has been and still is challenged about its role in the management of breast lesions. Guidelines today mandate that breast lesions should be managed with a triple assessment system consisting of clinical, radiological, and pathological evaluation.
Aim: This article will try and clarify whether FNAC stands as a tool in this assessment.
Materials and methods: PubMed was searched for articles concerning prospective, retrospective and review studies about clinical applications of FNAC.
Results: Specialists agree and evidence occurs that FNAC could be the examination of first choice in matters of pathological evaluation.
Conclusions: It is an easily performed, patient-friendly and cheap examination. It can successfully and quite quickly filter out benign breast conditions without any further cost or stress to the patient. In cases with inconclusive results or insufficient samples it should be followed by needle core biopsy (NCB). As a method, it has its limitations. It cannot directly provide information about tissue architecture, and identify certain breast conditions. Modern developments in liquid based cytology (LBC) upgrade its role in neoadjuvant chemotherapy too. In order to have satisfactory results, high levels of experience are required.
Keywords: FNA cytology; LBC; NCB; benign; breast disease; malignant; methylation.