Research

Imprint cytology on microcalcifications excised by Vacuum-Assisted Breast Biopsy: A rapid preliminary diagnosis

Maria Fotou³ , Vassiliki Oikonomou³ , Flora Zagouri⁴ , Theodoros N Sergentanis⁴ , Afroditi Nonni¹ , Pauline Athanassiadou² , Theodora Drouveli³ , Efstratios atsouris¹ , Evagelia Kotzia³ and George C Zografos⁴

¹  Department of Pathology, School of Medicine, Athens University, Greece

²  Department of Pathology, Laboratory Unit, School of Medicine, Athens University, Greece

³  Department of Cytology, Hippocratio Hospital, Athens, Greece

⁴  Department of Surgery, Breast Unit, 1st Department of Surgery, School of Medicine, Athens University, Greece

author email corresponding author email

World Journal of Surgical Oncology 2007, 5:40doi:10.1186/1477-7819-5-40

Published:	3 April 2007

Abstract

Background

To evaluate imprint cytology in the context of specimens with microcalcifications derived from Vacuum-Assisted Breast Biopsy (VABB).

Patients and methods

A total of 93 women with microcalcifications BI-RADS 3 and 4 underwent VABB and imprint samples were examined. VABB was performed on Fischer's table using 11-gauge Mammotome vacuum probes. A mammogram of the cores after the procedure confirmed the excision of microcalcifications. For the application of imprint cytology, the cores with microcalcifications confirmed by mammogram were gently rolled against glass microscope slides and thus imprint smears were made. For rapid preliminary diagnosis Diff-Quick stain, modified Papanicolaou stain and May Grunwald Giemsa were used. Afterwards, the core was dipped into a CytoRich Red Collection fluid for a few seconds in order to obtain samples with the use of the specimen wash. After the completion of cytological procedures, the core was prepared for routine histological study. The pathologist was blind to the preliminary cytological results. The cytological and pathological diagnoses were comparatively evaluated.

Results

According to the pathological examination, 73 lesions were benign, 15 lesions were carcinomas (12 ductal carcinomas in situ, 3 invasive ductal carcinomas), and 5 lesions were precursor: 3 cases of atypical ductal hyperplasia (ADH) and 2 cases of lobular neoplasia (LN). The observed sensitivity and specificity of the cytological imprints for cancer were 100% (one-sided, 97.5% CI: 78.2%–100%). Only one case of ADH could be detected by imprint cytology. Neither of the two LN cases was detected by the imprints. The imprints were uninformative in 11 out of 93 cases (11.8%). There was no uninformative case among women with malignancy.

Conclusion

Imprint cytology provides a rapid, accurate preliminary diagnosis in a few minutes. This method might contribute to the diagnosis of early breast cancer and possibly attenuates patients' anxiety.