Fine-needle aspiration of breast cancer: Relationship of clinical factors to cytology results in 689 primary malignancies

Barrows, George H.; Anderson, T. J.; Lamb, Joanne; Dixon, JM

doi:10.1002/1097-0142(19861001)58:7<1493::aid-cncr2820580720>3.0.co;2-f

Cited by 113 publications

(28 citation statements)

References 18 publications

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“…1 Cytologists reporting breast specimens are well aware that consultants and senior registrars perform much better than inexperienced junior staV, particularly in achieving an adequate specimen. Pathologists have been shown to be highly eVective aspirators of breasts and non-breast lesions.…”

Section: Discussionmentioning

confidence: 99%

Improved FNA cytology results with a near patient diagnosis service for non-breast lesions.

Mayall

Denford²,

Chang³

et al. 1998

J Clin Pathol

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Aim-To review fine needle aspiration (FNA) cytology from sites other than the breast a year before and a year after the introduction of a near patient FNA diagnosis (NPFD) service in which the FNA were performed by a pathologist and reported within a few minutes. Methods-The setting was a large hospital in rural New Zealand. The year before the introduction of the NPFD service was examined retrospectively, and the year after prospectively. The pattern of use and the quality of the results before and after starting the NPFD service were compared. Results-Time taken to report the specimens decreased from a few days to a few minutes. There were statistically significant changes in the following: an increase from 237 to 304 in the number of nonbreast FNA performed, and in particular an increase from 65 to 113 in the number for general surgery; an increase in the use of immunolabelled flow cytometry from 0 to 19 and cell blocks from 3 to 41; an increase in specificity from 53% to 80%; a decrease in the overall inadequacy rate from 29% to 9%; and a decrease in the inadequacy rate for cancers from 9% to 2%. The cost of the non-breast FNA service increased by about £9200 a year. Conclusions-Starting an NPFD service for sites other than the breast greatly reduced the reporting time and produced statistically significant increases in the use of FNA cytology and in the quality of the results. (J Clin Pathol 1998;51:541-544) Keywords: near patient diagnosis; fine needle aspiration cytology; auditIn this study we reviewed the pattern of use and quality of fine needle aspiration (FNA) diagnoses from sites other than the breast a year before and a year after the introduction of a near patient FNA diagnosis (NPFD) service. The setting was a large general and tertiary referral hospital (750 beds) servicing approximately 550 000 people in a rural area of New Zealand. MethodsThe first year was examined retrospectively and the second year-after the introduction of the NPFD service-was examined prospectively. The information collected for each case included the case number, the patient identification, the clinical specialty, the FNA operator, the FNA reporter, the cytological diagnosis, the results of any histology related to the FNA sampled lesion, and the follow up from the clinical notes for those lesions with no clear final diagnosis. In our laboratory the cytological diagnosis is coded according to the NHS Breast screening programme guidelines for cytology procedures and reporting in breast cancer screening (available from NHSBSP publications, Fulwood House, SheYeld S10 3TH, UK): C1, inadequate; C2, benign; C3, atypical; C4, suspicious; C5, malignant. These codes and the related performance statistics are comprehensively defined and widely understood. They were originally intended to apply to breast cytology but they are applicable to all FNA cytology. The significance of diVerences between the first and second years was tested with the 2 test with Yates' correction using a computer program "Chi-square V2.0" from

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Section: Discussionmentioning

confidence: 99%

Improved FNA cytology results with a near patient diagnosis service for non-breast lesions.

Mayall

Denford²,

Chang³

et al. 1998

J Clin Pathol

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“…It is worth noting that the 20% termed suspicious for the screening series was double that found in our larger series of symptomatic cases. 6 The most likely explanations for this include poor representation of malignant cells in the specimen as a consequence of size and occult nature, as well as the tendency of screening cancers to be well differentiated or of special type,'3 rendering unequivocal cytological distinction of malignancy more difficult.…”

Section: Discussionmentioning

confidence: 99%

Role of fine needle aspiration cytology in breast cancer screening.

Lamb¹,

Anderson²,

Dixon³

et al. 1987

J Clin Pathol

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“…Even when targeted accurately and sampled, interpretation may be difficult. To reduce geographical misses during aspiration and improve pathological interpretation, experienced aspirators and pathologists are respectively key (10,11).…”

Section: Discussionmentioning

confidence: 99%

Primary breast sarcoma: case report

Saidi

Adari

2004

E Af Med Jrnl

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SUMMARYPrimary breast sarcoma is a rare entity occurring in 0.5% of women with breast malignancy. Like in breast carcinoma, delay in its diagnosis has important clinical and treatment implications. The subject of this report presented at our breast unit with advanced breast lesion months after she noticed a small lump in her right breast. She had no clear diagnosis despite several consultations, in-patient treatments at two facilities in the city, breast ultrasonography, breast mammography and three fine needle aspiration cytology (FNAC) examinations. The patient needed multiple blood transfusions. A final FNAC showed ductal carcinoma. Histology following wide excision confirmed high-grade primary stromal breast sarcoma. She required adjuvant combination chemotherapy. A combination of diagnostic failures and patient fault caused delay in subject's treatment. Lesion progression during delay which influenced the pattern of physical morbidity, tumour prognosis and need for adjuvant treatment. Embracing the concept of breast care in dedicated breast units may minimise such treatment delays.

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Fine-needle aspiration of breast cancer: Relationship of clinical factors to cytology results in 689 primary malignancies

Cited by 113 publications

References 18 publications

Improved FNA cytology results with a near patient diagnosis service for non-breast lesions.

Improved FNA cytology results with a near patient diagnosis service for non-breast lesions.

Role of fine needle aspiration cytology in breast cancer screening.

Primary breast sarcoma: case report

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