Breast Fine-needle Aspiration:A Comparison of Thin-layer and Conventional Preparation

Abstract

Two hundred forty-two breast fine-needle aspirates prepared by the Cytyc ThinPrep Processor were compared with aspirates prepared by the conventional smear method. Palpable and nonpalpable mammographic breast lesions were aspirated and the first half of the aspirate was submitted for conventional smears and the second half was rinsed into a proprietary fixative and loaded on the ThinPrep Processor for monolayer slide preparation. The matched pairs were diagnosed and analyzed separately in a double-blinded manner and later paired for comparison. Diagnoses correlated exactly in 62% of cases. The diagnosis of fibroadenoma was made in only 4 of 21 cases on ThinPrep (19% correlation). Semiquantitative analysis of several cytologic features indicated potential pitfalls for accurate diagnosis using the ThinPrep Processor. These included loss of background constituents (such as stroma and adipose tissue), decreased cellularity and single ductal epithelial cells, and decreased cytologic detail including size, shape and nuclear texture. The ThinPrep Processor may play a role in breast fine-needle aspiration, but further investigation is warranted before it is used as a sole preparatory method.

Manual Liquid Based Cytology in Breast Fine Needle Aspiration – Comparison with the Conventional Smear

“…4,6,17,18 On the other hand, alterations in architecture and cellular morphology as well as loss of informative background are usually seen in FNA smears prepared by LBC. 16,17,19,20,21 In the present study, the age range and mean age was comparable with other studies. 4,16,19 In our study 53% of tumours were located in the right breast whereas 47% of tumours were located in the left breast which was similar to the findings of Ryu HS et al 16 In the present study we compared 100 MLBC and conventional FNA smears on following Cytomorphological parameters:-…”

“…Perez-Reyes et al 19 employed split sampling technique where they divided the aspirate into two halves, one for LBC and the other for CS, hence in their study the cellularity of LBC was inferior to CS. Gerhard R et al 22 observed that the number of passes performed and the skills of the person performing the procedure determine the quality and cellularity of the samples.…”

“…Most of the MLBC smears showed cells arranged in monolayered sheets that enabled us to study the cell morphology even better which was also observed by Pawar PS et al 24 In the present study that there was an apparent decrease in number of myoepithelial cells in MLBC smears as compared to CS which was also observed by other authors. 17,18,19 …”

Fine needle aspiration (FNA) biopsy of palpable breast masses

“…Similar to Leung et al 5 and Perez-Reyes et al 7 , we discovered the cytoplasmic characteristics to be comparable in both the CS and thin-layer methods of preparation; however, we found notable qualitative differences in the nuclei of both ductal and myoepithelial cells in our study. Ductal and myoepithelial cell nuclei tended to have visible small nucleoli, and the chromatin pattern was more enhanced in MP slides compared with CS slides.…”

“…[5][6][7] We were very careful to obtain equivalent cellular material for both methods, and yet we noticed that in many cases there seemed to be only enough fluid to make one slide, with only a small residual amount of fluid left in the vial. We therefore suspect that significant cellular loss probably occurred during one or more of the several MP processing steps.…”