Inadequate rates are lower when FNAC samples are taken by cytopathologists

Abstract

Inadequate rates (IR) in FNAC from different sources were compared. The rates were lowest when FNAC was performed by a cytopathologist (12%) and highest when done by a non-cytopathologist (32%). These differences were mirrored in high IRs in breast cancer cases. IR was not significantly improved when non-cytopathologist FNAC was attended by a cytotechnician.

Is there still a role for fine-needle aspiration cytology in breast cancer screening?

“…[10][11][12][13]24 The experience in breast cytology and in sampling techniques 11,12,25 associated with the onsite evaluation of FNAC specimens have been reported to provide an accurate assessment and more efficient clinical care of patients. 10,13,15 In this context, the cost-effectiveness of FNAC 10,13,15 makes it one of the better methods to apply during the course of a breast cancer screening program.…”

“…4,[7][8][9] The IR for FNAC is inversely proportional to the operator's level of experience and the presence of specialized cytologists. [10][11][12][13] Radiologic imaging 5,6 and the type of guidance system used are additional factors that could affect the performance of FNAC. 5 Diagnostic accuracy can be achieved through a multidisciplinary consultation, combining FNAC results with clinical and radiologic data (the triple test).…”

Efficacy of fine‐needle aspiration biopsy in diagnosis of breast cancer: A retrospective study of 303 cases in Bahrain

“…The cytopathologist (aspirator) experience along with considering the overall clinical context holds as the major factor that contributes to the less percentage of unsatisfactory aspirates and it has been well documented that unsatisfactory aspirates is significantly lower in specialist breast clinics where the cytologist perform the FNAB himself compared to those samples that have been mailed to the laboratory from other clinics. 5,6 The overall FN rate in our study was 0.67% and it is generally less than 5% in most reported studies. 7,8 The two true FN cases were in the benign (C2) category.…”

Training, credentialing and re‐credentialing for the performance of a thyroid FNA: A synopsis of the National Cancer Institute Thyroid Fine‐Needle Aspiration State of the Science Conference

“…38,39 Another report evaluating FNAs from various sources reported a lower rate of unsatisfactory FNA samples when the aspirates were performed by cytopathologists (32 vs. 12%). 40 This distinction was not corrected for by on-site adequacy assessments. 40 The indications for FNA on palpable and US localized thyroid nodules are discussed in the accompanying publication in this issue by Cibas et al 41 The replacement of palpation-guided FNA with ultrasound-guided FNA for palpable lesions has been reported as a way to decrease the unsatisfactory rate.…”

“…40 This distinction was not corrected for by on-site adequacy assessments. 40 The indications for FNA on palpable and US localized thyroid nodules are discussed in the accompanying publication in this issue by Cibas et al 41 The replacement of palpation-guided FNA with ultrasound-guided FNA for palpable lesions has been reported as a way to decrease the unsatisfactory rate. In two studies, 42,43 the palpationguided FNAs were performed by many physicians whereas all the ultrasound guided FNAs were performed by a single radiologist.…”