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A Program for Staged Implementation

John S. Abele, MD; Theodore R. Miller, MD; William H. Goodson, III, MD; Thomas K. Hunt, MD; David C. Hohn, MD

Arch Surg. 1983;118(7):859-863.

Abstract
• Fine-needle aspiration (FNA) can provide a morphologic diagnosis of palpable breast masses in an accurate, efficient, inexpensive, and safe manner. However, how one acquires the skill to perform the FNA and interpret the resulting smears, while protecting the patient from the risk of false-positive or false-negative results, is scarcely considered. We used a three-phase program to acquire experience with FNA while providing services for 205 patients over a 16-month period. We performed FNA sequentially in vitro, in vivo, and finally in vivo for clinical use. With available literature and this graduated implementation program, physicians totally inexperienced with FNA can achieve results similar to those of medical centers having experience with thousands of patients.

(Arch Surg 1983;118:859-863)

Author Affiliations
From the Departments of Surgery (Drs Hunt, Goodson, and Hohn) and Pathology (Drs Abele and Miller), University of California School of Medicine, San Francisco.

Footnotes
Accepted for publication Dec 13, 1982.

Reprint requests to Department of Pathology, HSW 501, University of California School of Medicine, San Francisco, CA 94101 (Dr Abele, c/o Dr Miller).

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