Paired ductal lavage and fine-needle aspiration specimens from patients with breast carcinoma

Abstract

Ductal lavage (DL) is a new procedure for sampling of the mammary epithelium, but experience with this technique remains limited. We compared the findings in paired DL and fine-needle aspiration (FNA) specimens obtained from patients with breast carcinoma. Four reviewers evaluated all DL samples. Two reviewers also examined the FNA material and compared cellular composition and morphologic findings in paired samples. DL and FNA samples from six patients were satisfactory for evaluation. Two DL samples showed marked atypia, one showed mild atypia, and two were benign; there was no agreement in one case (mild atypia vs. benign). Overall, the atypical cells in DL samples resembled those in the paired FNA material, but low degree of cytologic atypia and relative paucity of atypical cells limited their correct identification. The interpretation of DL samples is more challenging than that of FNA material, but similar criteria apply. To increase the sensitivity of DL, the number of epithelial cells required for a satisfactory sample should be higher than previously set.

The Importance of Cytologic Intrarater and Interrater Reproducibility: the Case of Ductal Lavage

“…Further studies are needed to determine if intrarater and interrater reliability of DL cytology can be improved by more extensive formal training, changes to the classification, or increases in cellular yield (12,13). Formal training in sample procurement and reading of slides has been shown to improve the sensitivity and specificity of FNA interpretation.…”

Fluorescence in situ hybridization of ductal lavage samples identifies malignant phenotypes from cytologically normal cells in women with breast cancer

“…Another technique similar to DL, random periareolar FNA (RPFNA), may be better for obtaining ductal fluid 17. In the prevention setting, it has been reported that RPFNA provides sufficient epithelial cells for cytologic and molecular evaluation in 95% of high‐risk women undergoing the procedure 16.…”

Cytologic Findings of Breast Ductal Lavage and Concurrent Fine Needle Aspiration in Pleomorphic Lobular Carcinoma in Situ

“…2 Literature reports cytologic findings in DL 3,4 but cytologic comparison of DL with concomitant FNA is limited. Brogi et al 5 reported that atypical cells in DL resembled those in paired FNA; however, in DL the degree of cytologic atypia is lower and there is generally a paucity of atypical cells. 5 In this case study, DL and FNA were both highly cellular and presented with similar cells.…”

“…Brogi et al 5 reported that atypical cells in DL resembled those in paired FNA; however, in DL the degree of cytologic atypia is lower and there is generally a paucity of atypical cells. 5 In this case study, DL and FNA were both highly cellular and presented with similar cells. Atypical epithelial cells in DL were predominantly in small aggregates and sometimes in single-file or single-lying, whereas in FNA the atypical cells were predominantly single-lying but also appeared in loosely cohesive aggregates.…”