Immunohistochemistry Applied to Breast Cytological Material

Pinto, Daniel; Schmitt, Fernando

doi:10.1159/000522542

Cited by 15 publications

(14 citation statements)

References 140 publications

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“…IHC is a useful tool for providing additional information on FNAB specimens. In fact, several studies have highlighted the usefulness of IHC analysis to distinguish benign from malignant cytological samples [ 9 ]. More specifically, the combination of antibodies specific for p63 and a cytoplasmic marker, such as 34 β E12 or cytokeratin 5/6, has proven useful for this purpose [ 10 , 11 ], as we have also reported in tissues [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Combined Use of Cell Block and Smear Improves the Cytological Diagnosis of Malignancy in Non-Palpable Breast Lesions Screened by Imaging

Nishimura

Oiwa

2023

Analytical Cellular Pathology

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Background. Currently, core needle biopsy is replacing fine needle aspiration biopsy (FNAB) for pathological diagnosis of breast lesions. However, FNAB is extensively used for diagnosing breast lesions, including screened lesions, at our hospital. Furthermore, direct smears as well as cell blocks (CBs) from the FNAB specimens have been used. To prepare the CBs, hematoxylin and eosin (HE) staining as well as immunostaining with a mixture of p63 and cytokeratin 5/6 antibodies are routinely used. Therefore, in the current study, we sought to assess the efficacy of diagnosing breast lesions using conventional smears and CB immunostaining. Methods. Breast FNAB reports of direct smears and CBs from The Nagoya Medical Center between December 2014 and March 2020, were reviewed. The efficiency of diagnoses made with direct smears and CBs were compared using histology-based diagnoses. Results. Among the 169 histologically confirmed malignant lesions, 12 lesions that were reported as unsatisfactory, benign, or atypia probably benign, using direct smears were diagnosed as malignant using CB. Histologically, these lesions were diagnosed as carcinomas with mild atypia or papillary structures. Ten (83.3%) of the twelve lesions were non-palpable and only detected upon imaging. Conclusion. Combined use of CB and conventional smear leads to the detection of more malignant lesions in breast FNAB specimens, particularly in lesions detected by imaging alone. Immunostaining of CB sections using a mixture of p63 and cytokeratin 5/6 antibodies provides more information than HE staining alone. Breast FNAB with CB preparation can be successfully applied for evaluation of breast lesions in developed countries.

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Section: Discussionmentioning

confidence: 99%

Combined Use of Cell Block and Smear Improves the Cytological Diagnosis of Malignancy in Non-Palpable Breast Lesions Screened by Imaging

Nishimura

Oiwa

2023

Analytical Cellular Pathology

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“…As a component of triple test, it is the initial method of assessment pathologically, in the diagnosis of breast lesions in developing nations. Moreover, its role is not just confined to diagnosis, but also, in the elucidation of prognostic information by assessment of hormone receptor expressions [21]. A recent review article documented specificity of the FNAC of the breast, ranging from 60% to 100% and sensitivity from 76% to 99% [22].…”

Section: Discussionmentioning

confidence: 99%

Correlative Evaluation of Seven Cytological 3-Tier Grading Systems of Breast Carcinoma with the Standard Histological Grading: A 4 and ½ Year Study

Pai¹,

Doreswamy²

2023

Acta Cytologica

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Introduction: The early diagnosis of breast carcinoma is of paramount importance in its management. Fine Needle Aspiration Cytology (FNAC) has the potential to play a pivotal role in providing the relevant information on the aggressiveness of this tumor. But there is no gold standard when it comes to cytological grading of breast carcinoma as there is no consensus between the pathologist and also the clinicians as to which grading is as par with the gold standard Elston -Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading. This study was undertaken to study seven cytological 3-tier grading systems, namely Robinson’s, Fisher’s, Mouriquand’s, Dabbs’, Khan’s, Taniguchi’s and Howells’s and to correlate them with the Elston-Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading system so as to determine the finest cytological grading system which could be reliably used in our routine practice Material & Methods: A total of 117 breast carcinoma cases diagnosed on FNAC were graded using seven 3-tier cytological grading systems and were correlated with Elston-Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading system. Concordance, kappa measurement and various correlation studies were done using SPSS software version 2021. Results: Robinson’s method showed a better concordance (84.61%), a better correlation (Spearman 𝜌 = 0.750, tau = 0.731, p= <0.001) and a substantial kappa value of agreement (𝜅 =0.701) with SBR grading system compared to other system closely followed by Fisher’s system. Conclusions: Even though all the seven 3-tier cytological grading systems positively correlated with the SBR histologic grading of breast carcinoma, Robinson’s method showed better concordance and correlation with a substantial kappa value of agreement in comparison to other 3-tier cytology grading systems. Hence Robinson’s grading which is simpler and also feasible should be incorporated in the routine cytology reporting of breast carcinoma. Key Words: Robinson’s grading, 3-tier Cytological grading, Scarff-Bloom-Richardson grading, Breast Carcinoma

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“…The role of cytology is not just limited to diagnosis anymore. Significant prognostic information including even hormonal receptor expression in breast carcinomas can be assessed from FNAC smears [ 17 ]. If the grade of the tumour too can be obtained from FNAC smears, it will be immensely useful to the treating clinician.…”

Section: Discussionmentioning

confidence: 99%

Cytological Grading of Breast Carcinomas and Its Prognostic Implications

Rajendran¹,

Sudalaimuthu²,

Ganapathy³

2022

Cureus

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IntroductionDetermining the histological grade of breast carcinomas before mastectomy is necessary to decide about neoadjuvant chemotherapy. Core needle biopsies used for this purpose often under-grade the tumour. The grade obtained from fine needle aspiration cytology samples will help in such situations and whenever biopsy is not done, as in a resource-poor setup. Many studies are being done to find out the cytological grading system that correlates well with histological grading. MethodsThis study was done between 2016 and 2019 including the cases in which both modified radical mastectomy and fine needle aspiration of the tumour had been done. Robinson's cytological grading was done in Papanicolaou and haematoxylin & eosin (H&E) stained cytology smears and correlated with modified Bloom-Richardson histologic grading done in modified radical mastectomy specimens. We also studied the prognostic significance of Robinson's method by studying the association between cytological grade and lymph node metastasis. ResultsSixty cases were studied. The two methods had the same grade in 49 (81.7%) cases. They showed a significant positive correlation (Spearman correlation coefficient 0.848, p-0.0001), significant association (Chi-square test, p-0.0001), and substantial agreement (kappa value 0.72). Multiple regression analysis showed chromatin score and nucleoli score as the most influential parameters. Lymph node metastasis showed significant association with cytological grade (p-0.0003), cell dissociation score (p-0.0001), nucleoli score (p-0.01), and chromatin score (p-0.04). ConclusionRobinson's cytological grading is a simple, reliable adjunct/alternative to core needle biopsies for grading breast carcinomas before mastectomy. Hence, it can be made a part of routine cytology reporting of breast carcinomas. Further long-term studies will help in confirming its prognostic significance.

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Immunohistochemistry Applied to Breast Cytological Material

Cited by 15 publications

References 140 publications

Combined Use of Cell Block and Smear Improves the Cytological Diagnosis of Malignancy in Non-Palpable Breast Lesions Screened by Imaging

Combined Use of Cell Block and Smear Improves the Cytological Diagnosis of Malignancy in Non-Palpable Breast Lesions Screened by Imaging

Correlative Evaluation of Seven Cytological 3-Tier Grading Systems of Breast Carcinoma with the Standard Histological Grading: A 4 and ½ Year Study

Cytological Grading of Breast Carcinomas and Its Prognostic Implications

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