Fine‐needle aspiration cytology as the first pathological diagnostic modality in breast lesions: A comparison with core needle biopsy

Park, Sang-Mo; Lee, Dong-Wha; Jin, So-Young; Kim, Dong-Won; Jeen, Yoon-Mi; Choi, In Keun

doi:10.1111/j.1755-9294.2009.01062.x

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…Larger tumors carried a higher risk of malignancy. Similar observations were made in the HBC study where the diagnostic accuracy was higher for larger lesions (over 1 cm) [ 31 ].…”

Section: Discussionsupporting

confidence: 86%

“…In previous studies on HBC, the diagnostic accuracy of FNAC in the evaluation of breast lesions compared with histopathology ranged from 90.1% to 95.1%; sensitivity varied from 93.8% to 97.7%, and specificity varied from 80.8% to 100% [ 31 – 33 ]. In CMTs reports, diagnostic agreement of cytological examination for differentiating malignant and benign lesions varied from 63% [ 34 ] to 81.4% [ 8 ], sensitivity ranged from 25% [ 21 ] to 95.23% [ 5 ], and specificity from 49% [ 21 ] to 96% [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic efficacy of smear cytology and Robinson’s cytological grading of canine mammary tumors with respect to histopathology, cytomorphometry, metastases and overall survival

et al. 2018

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Cytology is a simple, rapid, and inexpensive method used for pre-operative diagnosis of canine mammary tumors (CMTs) in veterinary practice. Studies related to human breast cancer showed the Robinson’s grading system—established for invasive ductal carcinoma, not otherwise specified (IDC, NOS) and used on cytological material—to not only closely correspond to the histopathological grading but also be helpful in assessing prognosis and selecting most suitable treatments before surgery. The objectives of this study were: to evaluate the accuracy of cytological diagnosis and cytological Robinson’s grading system compared to the histopathological examination of CMTs; to compare of cytological features and cytomorphometric parameters with tumor behavior, as well as cytological and histological grading; and to determine an association of the Robinson’s grading system and cytological background details with metastases, and patients’ survival. We report substantial diagnostic accuracy in detecting simple types and high grade tumors. Cytological diagnosis of tumor behavior showed relatively low sensitivity and specificity compared to human studies, and this might be caused by the heterogeneous morphology of CMTs. The presence of mucosecretory material and extracellular matrix was not significantly associated with tumor behavior. We report a positive correlation between both grading systems and cytological features (included in Robinson’s grading), the presence of necrotic debris, inflammation, and red blood cells. A negative correlation was determined only for the presence of extracellular matrix. The univariate and multivariate analyses confirmed a significantly higher risk of developing metastasis and shorter overall survival for dogs with tumors of grade 2 or 3 on cytology. In addition, these tumors were the most common cause of CMT-related deaths in dogs. Taken together, our findings suggest that the Robinson’s method of cytological grading applied for malignant CMTs evaluated in cytological smears regardless of tumor type can be adapted to veterinary cytology. Additionally, some background features seem to aid malignancy assessment.

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“…Larger tumors carried a higher risk of malignancy. Similar observations were made in the HBC study where the diagnostic accuracy was higher for larger lesions (over 1 cm) [ 31 ].…”

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Diagnostic efficacy of smear cytology and Robinson’s cytological grading of canine mammary tumors with respect to histopathology, cytomorphometry, metastases and overall survival

et al. 2018

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“…The false negative rate for CNB reaches 9.9% ( 12 ) . Lower sensitivity is linked with the presence of non-diagnostic specimens resulting from difficulties in obtaining the material (sampling error), heterogeneous structure of carcinomas and, more rarely, from an erroneous histopathological assessment (a diagnostic error).…”

Section: Introductionmentioning

confidence: 99%

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Łukasiewicz¹,

Ziemiecka²,

Jakubowski³

et al. 2017

J Ultrason

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AimThe aim of the study was to review two techniques that can be used to verify focal lesions in the breasts: fine-needle aspiration biopsy and core-needle biopsy.Material and methodsFifty-five articles (original papers and reviews), half of them published within the past 5 years, were included in the analysis. The authors also took their own experience into account.ResultsPre-operative assessment of focal lesions in the breasts is crucial in the planning of further therapeutic management. The role of fine-needle aspiration biopsy has been reduced lately due to its low sensitivity and specificity as well as a high rate of non-diagnostic, suspicious and false negative results. This method does not enable one to differentiate between in situ and invasive disease. Currently, fine-needle biopsy is recommended for cystic lesions, suspected of being recurrences in the chest wall, and lymph node metastases. Core-needle biopsy is the basic diagnostic method of breast lesions. According to the recommendations of the Polish Ultrasound Society and American College of Radiology, BIRADS 4 and 5 lesions should be evaluated histopathologically. Core-needle biopsy makes it possible to establish a final diagnosis more frequently than fine-needle biopsy, both in the case of benign and malignant lesions. It delivers more information about the nature of a tumor (mutation of HER-2, estrogen and progesterone receptors and Ki-67 index). Its limitations include: underestimation of invasion and failure to recognize the components of ductal carcinoma in situ in papillary and atypical lesions. Single fine-needle aspiration biopsy is inexpensive, but when considering the cost of further diagnosis due to non-diagnostic, suspicious and atypical results, this method generates high additional costs.ConclusionsMicroscopic verification of focal breast lesions is crucial for further therapeutic decisions. It has been proven that histopathological verification is more accurate and has more advantages than cytological assessment.

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“…Core needle biopsy may be used as a second line diagnostic tool in lesions which yields insufficient cells and equivocal diagnosis. 13,14 Thus FNAC requires an excellent aspirator to obtain satisfactory material and breast cytolopathologic expertise in interpreting the breast aspiration. 15 Though the cases were reported in C1-C5 category, a specific cytologic diagnosis was given in cases wherever possible.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Benign Breast Lesions : A Cytologic Study

Nirmala¹,

Sejekan²,

Dayananda³

2015

jemds

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INTRODUCTION:Open biopsy is widely considered to be the procedure of choice for diagnostic tissue sampling of bone tumors. However, associated disadvantages include in-patient procedure requiring hospitalization, risk of infection, hematoma formation and pathological fractures. As an alternative FNA cytology is increasingly used as a diagnostic modality. It is a challenging technique due to difficulties in approaching bone lesions and obtaining adequate material. AIMS: 1. To study the prevalence and distribution of various breast lesions in women of various age groups. 2. To classify the smears into C1-C5 category. 3. To enumerate the difficulties encountered in this study. 4. To emphasize the role of FNAC in diagnostic workup in breast lesions. MATERIALS AND METHODS: FNAC was done on 208 cases of breast lesions from September 2011 to July 2012 in department of Pathology, Bowring hospital, BMC&RI, Bangalore. Cases presenting to the OPD with breast lumps were subjected for FNAC. Aspirations were carried out with 10ml disposable syringe with a 22guage needle, material was obtained. Aspirates were smeared and few of them were immediately fixed with methanol and stained with H&E, rest of the smears were air dried for MGG staining. The diagnostic criteria C1-C5 as recommended by NHS breast screening program has been incorporated for reporting the slides along with pathological diagnosis wherever possible. RESULTS: 1. In countries with limited resources like India, FNAC may be used as the first line of diagnostic tool for evaluating breast lesions. 2. Breast FNA continues its monopoly over core biopsy and open excision biopsy. Benign conditions of breast can be diagnosed easily on FNA if done accurately. The current usage of C1-C5 categories in typing the breast lesions gives a wide scope for pathologist to place the doubtful lesions freely in the categories. However a disease specific diagnosis was preferred by the clinicians. 3. In females the commonest benign lesion encountered was fibroadenoma (43.5%) followed by benign breast disease (20.12%) &fibro cystic disease (11.03%). 4. In males the commonest cause of breast enlargement was benign breast disease(gynaecomastia) (91%) followed by fibroadenoma in( 9%).

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Fine‐needle aspiration cytology as the first pathological diagnostic modality in breast lesions: A comparison with core needle biopsy

Cited by 8 publications

References 26 publications

Diagnostic efficacy of smear cytology and Robinson’s cytological grading of canine mammary tumors with respect to histopathology, cytomorphometry, metastases and overall survival

Diagnostic efficacy of smear cytology and Robinson’s cytological grading of canine mammary tumors with respect to histopathology, cytomorphometry, metastases and overall survival

Fine-needle versus core-needle biopsy – which one to choose in preoperative assessment of focal lesions in the breasts? Literature review

Spectrum of Benign Breast Lesions : A Cytologic Study

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