Improved Breast Cytology Results with Near Patient FNA Diagnosis

Hamill, James; Campbell, Ian; Mayall, Frederick; Bartlett, Adam; Darlington, A

doi:10.1159/000326710

Cited by 18 publications

(10 citation statements)

References 23 publications

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“…USG is a reliable tool, particularly for deep and small thyroid nodules, and it helps to predict the presence of malignancy in a nodule using sonographic features (nodules that include micro calcification, a solid component, abnormal cervical lymph nodes etc.) [34], [35], [36], [37], [38], [39]. In a systemic review and meta-analysis carried out by Schmidt et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 1869 thyroid ultrasound-guided fine-needle aspiration biopsies between general surgeons and interventional radiologists

Bozkurt

İrkörücü

Aziret

et al. 2016

Annals of Medicine &Amp; Surgery

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BackgroundThyroid nodules are commonly encountered problems in clinical practice. For patients who have a thyroid nodule, the fine-needle aspiration biopsy (FNAB) is the most important test, as it is the most reliable diagnostic method for distinguishing between benign thyroid nodules and cancerous nodules. FNAB is able to be performed either via an ultrasound (USG) or alone and is the first choice when it comes to diagnosing thyroid nodules, given that it is cheap, safe and provides accurate results.ObjectiveIn this study-a retrospective analysis of FNAB via USG - our aim is to evaluate the multiple variables related to FNAB procedures, including the experience of the person performing the biopsy, the age and gender of the patient, the number of nodules, the size of the nodule(s) and the number of lams recorded from the cytopathology report on non-diagnostic rates, conducted at an invasive radiology clinic and at a general surgery clinic.Materials and methodsA total of 1062 patients involving 1869 nodules, examined using FNAB via USG, were reviewed retrospectively from records dated between November 2011 and July 2014 and from pathology reports taken from the ANEAH General Surgery clinic and Interventional Radiology clinic. Cytopathology results were classified according to the 2007 Bethesda System for Reporting. Gender, age, number of nodules, diameter of the nodules, biopsied nodules, location of the nodules, number of lams, symptoms and the date of biopsies were the parameters used to examine the factors involved in non-diagnostic cytopathology invasive radiology. These parameters were inspected at both of the clinics (ANEAH General Surgery clinic and Interventional Radiology clinic). In analyzing the results, the statistical significance level was set at 0.05, where in cases that the p value was under 0.05 (p < 0.05), it was determined that no significant relationship existed. In this study, data were analyzed using SPSS 20 software.ResultsOf the nodules reviewed, 1620 were found on females and 249 on males. The age of the patients ranged from 10 to 87 years, with the mean age being 50 years. In the general surgery clinic, 470 nodules of 341 patients were aspirated, and in the interventional radiological clinic, 1399 nodules of 721 patients were aspirated. In the literature review conducted to compare statistical assessments of FNAB via USG, no significant difference was found between the ANEAH General Surgery clinic and the Invasive Radiology clinic (p > 0.05). In the invasive radiology clinic, non-diagnostic rates decreased with the increase in experience of the person who conducted the biopsy (p = 0.001).ConclusionThe results from both of the clinic's rates of non-diagnostic FNAB, performed via USG, were found to be acceptable. Our study also demonstrates that USG-guided FNAB can be performed with a low non-diagnostic rate as experience grows.

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Section: Discussionmentioning

confidence: 99%

Comparison of 1869 thyroid ultrasound-guided fine-needle aspiration biopsies between general surgeons and interventional radiologists

Bozkurt

İrkörücü

Aziret

et al. 2016

Annals of Medicine &Amp; Surgery

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“…Nevertheless, the majority of these comparisons had been performed using formalin-fixed paraffin-embedded blocks from surgical specimen for the qPCR analysis; very few used preoperative diagnostic tissue samples for this analysis, and in this case, mostly were an ultrasound (US)-guided coreneedle biopsy (CNB) (Beatty et al, 2004;Jacquemier et al, 2013;Kulka et al, 2006;Suo et al, 2004;Susini et al, 2010). US-guided fine-needle aspiration cytology (FNAC) is a less invasive and simpler way to obtain tumour tissue sample from suspicious breast lumps (Farshid et al, 2008;Hamill et al, 2002;Pagani et al, 2011;Uzan et al, 2009). It provides breast cancer diagnosis in 80%e90% of the cases, with high sensitivity (65%e99%) and specificity (96e100%); a predictive value of 99% and false negatives rates from 0 to 20%.…”

Section: Introductionmentioning

confidence: 99%

Concordance between HER‐2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients

et al. 2016

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Determining the status of HER2‐neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2‐neu amplification in case of IHC2+ using either a core‐needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine‐needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2‐neu status by using fine‐needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1‐day‐stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2‐testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87–1), specificity 98% (0.95–1) and positive and negative predictive values 88% (0.75–1) and 99% (0.98–1), respectively. In conclusion, our study demonstrates that qPCR performed using fine‐needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

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“…Because the accuracy of FNA largely depends on the cytopathologist's proficiency both in performing the aspirate and the cytomorphological analysis [3,4] and the identification of small pre-invasive lesions and well-differentiated tumors may be challenging [5], analyses of tumor associated DNA alterations could augment the accuracy of the evaluation of cellular morphology [3].…”

Section: Introductionmentioning

confidence: 99%

High RASSF1A promoter methylation levels are predictive of poor prognosis in fine-needle aspirate washings of breast cancer lesions

Martins

Monteiro

Ramalho-Carvalho

et al. 2010

Breast Cancer Res Treat

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Previously, we reported that the accuracy of cytological diagnosis of breast lesions could be augmented through the quantitative assessment of DNA methylation of fine-needle aspirate (FNA) washings. Herein, we aimed at the evaluation of the prognostic value of quantitative promoter methylation at three gene loci (APC, CCND2, and RASSF1A) in a large series of FNA washings from breast lesions. Methylation levels of three gene promoters were assessed by quantitative methylation-specific PCR in bisulfite-modified DNA from 211 FNA washings, comprising 178 carcinomas and 33 benign lesions, both histopathologically confirmed. Receiver operator characteristic (ROC) curve analysis was used to determine the diagnostic performance of the gene panel in distinguishing cancer from non-cancerous lesions. Relevant clinicopathologic data and time to progression and/or death from breast cancer were correlated with methylation findings. Log-rank test and Cox-regression model identified independent predictors of prognosis. APC, CCND2, and RASSF1A methylation levels differed significantly between malignant and benign lesions. ROC curve analysis confirmed the diagnostic performance of the gene panel. In univariate analysis, stage was significantly associated with overall, disease-specific and disease-free survival, whereas tumor grade was associated with disease-specific and disease-free survival. Remarkably, RASSF1A methylation was significantly and independently associated with worse disease-free survival in the final multivariate analysis. We confirmed that quantitative gene promoter methylation augments the diagnostic performance of cytopathology. Importantly, and in addition to standard clinicopathologic parameters, RASSF1A high-methylation levels are independent predictors of worse outcome in breast cancer. Thus, epigenetic biomarkers provide valuable tools for breast cancer patient management.

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Improved Breast Cytology Results with Near Patient FNA Diagnosis

Cited by 18 publications

References 23 publications

Comparison of 1869 thyroid ultrasound-guided fine-needle aspiration biopsies between general surgeons and interventional radiologists

Comparison of 1869 thyroid ultrasound-guided fine-needle aspiration biopsies between general surgeons and interventional radiologists

Concordance between HER‐2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients

High RASSF1A promoter methylation levels are predictive of poor prognosis in fine-needle aspirate washings of breast cancer lesions

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