Multinational study of oestrogen and progesterone receptor immunocytochemistry on breast carcinoma fine needle aspirates

Objective: Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies. However, the success of breast FNA is highly dependent on the adequate preparation of cytological conventional smears (CS). The liquid-based cytology (LBC) technique consists of an automated method for preparing thin-layer cytological samples from cell suspensions collected in alcohol-based preservative. LBC is designed to improve CS by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts. Study Design: We performed a review of the published literature about LBC applied to breast FNA. Results: LBC preparations of breast aspirates demonstrated better cellular preservation, less cell overlapping and elimination of blood and excessive inflammation compared to CS. Conversely, alterations in architecture and cell morphology as well as loss of myoepithelial cells and stromal elements have been described in LBC specimens, requiring training before applying this technique for diagnosis. Studies have shown a similar accuracy between LBC and CS for the diagnosis of breast lesions. LBC also permits the use of residual material for ancillary tests, which is an important advantage compared to CS. Conclusions: LBC can be safely applied to breast FNA, showing a similar diagnostic accuracy to CS.

Section: Ancillary Techniquesmentioning

confidence: 99%

Liquid-Based Cytology in Fine-Needle Aspiration of Breast Lesions: A Review

Gerhard

Schmitt²

2014

“…Liquid-based cytology (LBC) preparations usually show good reproducibility for ICC and are also suitable for preserving cell samples to provide high-quality DNA and RNA to use in several molecular assays such as PCR, RFLP, and even sequencing [1]. This characteristic makes LBC the ideal system for the evaluation of standard prognostic/predictive markers in breast cancer [2]. However, despite the specific benefits of one or another specimen/fixation technique for a particular assay, in our experience, formalin-fixed paraffin-embedded (FFPE) cell blocks are the best solution for performing ancillary tests on breast FNAB material.…”

Section: Introductionmentioning

confidence: 99%

“…Independently of the preparation technique, cell blocks stain in a highly reproducible manner and can be used to prepare enough slides for large ICC panels as well as for DNA and RNA extraction using standardized protocols thoroughly tested for paraffin-embedded tissues. ICC on FFPE cell blocks can also be performed with the major automatic and commercially available immunohistochemistry platforms, which allows for standardization of techniques using thoroughly validated protocols which lead to highly reproducible assays [2]. Therefore, while ICC and molecular techniques can be performed on several cytologic preparations, we recommend that, if possible, FFPE cell blocks should be obtained for all cases where there might be the need for ancillary studies including ICC or molecular assays.…”

Section: Introductionmentioning

confidence: 99%

Ancillary Tests in Breast Cytology: A Practical Guide

Beça

Schmitt

2019

Utilization of fine-needle aspiration biopsy (FNAB) cytology for the diagnosis of diseases of the breast has been met with both excitement and uncertainty during the last couple of decades. Presently, FNAB for the diagnosis of primary and metastatic breast lesions is on the rise again. This is probably due to its fast turnaround time, cost efficiency, and minimal invasiveness, characteristics of this sampling modality which are particularly crucial for patients requiring frequent repeat biopsy in the setting of metastatic lesions. In this article, we will briefly review the main modern applications of FNAB of the breast when coupled with contemporary ancillary techniques. Such contemporary ancillary techniques range from classic immunocytochemistry (ICC) to the most modern molecular techniques, particularly next-generation sequencing. Coupled with contemporary ICC and molecular methods, FNAB of the breast can be used for several applications. The applications reviewed in this article include the primary diagnosis of a breast lesion, the identification of the breast as a primary source of a metastatic lesion, the evaluation of breast prognostic/predictive markers, and the tracking of tumor evolution. In our opinion, FNAB of the breast is an ideal sampling method, sharing many of the advantages of truly liquid and of tissue biopsies. Ultimately, we aim at demystifying the complexity of many of the challenges traditionally associated with the application of ancillary techniques to FNAB of the breast and provide insights into some of the most cutting-edge and clinically useful application scenarios.

“…FNAC is a fast, low-cost technique, with great diagnostic accuracy and with minimum risks to patients [12,13,14,15]. Well-fixed smears along with the cell blocks obtained are optimal adjuncts to perform ancillary techniques, such as immunocytochemistry and molecular tests [16,17,18,19]. Moreover, FNAC has a great intrinsic potential (concerning cytomorphology) to supply additional information to the diagnosis of breast carcinoma for each case [17,18,19], which has been used in attempt to predict molecular phenotypes of breast carcinomas [20].…”

Section: Introductionmentioning

confidence: 99%

Cytological Criteria for Predicting the Luminal Phenotype of Breast Carcinoma

Paschoalini

Düfloth²,

Neto³

et al. 2016

Background: Specific cytological criteria for the luminal phenotype of breast carcinoma, despite it being the most common and having a better prognosis as well as targeted therapies under study, remain to be established. Using fine-needle aspiration cytology (FNAC), we aimed to identify the luminal phenotype through the evaluation of cytological criteria recognized in routine practice. Methods: We correlated 169 FNACs of breast carcinomas with their tissue specimens, classified into phenotypes by immunohistochemistry (applying tissue microarray technology) as luminal A, luminal B, HER2 overexpression, and triple negative. All FNAC samples were blindly reviewed according to cellularity, cell cohesion, necrosis, nucleoli, and nuclear atypia. Fisher's exact test was used to test associations between the cytological criteria and phenotypes. Results: The following phenotypes were obtained - luminal A: 107 (63.3%), luminal B: 39 (23.1%), HER2 overexpression: 8 (4.7%), and triple negative: 15 (8.9%). The luminal phenotype showed mild/moderate cellularity (40.4%) (OR = 7.12, 95% CI: 1.61-31.52), inconspicuous, present nucleoli (55.5%) (OR = 8.31, 95% CI: 2.36-29.19), and mild/moderate nuclear atypia (44.5%) (OR = 8.42, 95% CI: 1.90-37.25). Conclusion: The criteria that might indicate the luminal phenotype of breast carcinoma in FNAC were mild/moderate cellularity, inconspicuous, present, and nonprominent nucleoli, and mild/moderate nuclear atypia.