Standardization of fine needle aspiration cytology of the breast – comparison of Auto Cyto Fix and conventional smears

Abstract

In Japan, there are some problems with fine needle aspiration (FNA) cytology of the breast, such as insufficient smeared cells, air-drying artefact and excessive erythrocytes. Liquid-based cytology has been found to solve these problems. Equipment for such preparations has been developed, but can be expensive to purchase and operate. We developed Auto Cyto Fix 1000 (ACF), which is inexpensive and automatically smears and fixes cells. The purpose of this study was to compare the various cytological features of conventional and ACF specimens. We evaluated whether the ACF method would be able to replace the conventional method. Forty-eight FNA specimens of breast were studied. All specimens were prepared by the direct smeared (DS) and ACF methods and evaluated for unsatisfactory cell collection, air-drying artefacts, background findings and epithelial cell findings. Although ACF specimens were prepared using the cells remaining in the needle and syringe after preparing DS specimens, the cellularity of two of the ACF specimens was better than that of the corresponding DS specimens. ACF specimens never showed air-drying artefact. Unlike DS specimens, which have many erythrocytes in the background, erythrocytes were filtered out and the background of ACF specimens was clean. We believe that many problems attributable to conventional FNA specimen preparation have been solved in this study. Preparation using the ACF apparatus can reduce running costs and can be used to prepare FNA specimens of the breast for cytological examination as an alternative to the conventional method.

Fine Needle Aspiration of Borderline Ovarian Lesions

“…[54][55][56][57][58] Recent studies have suggested that problems with FNA cytology of the breast, such as insufficient cells or air-drying artifact, are solved by liquid-based technology. [55][56][57] FNA of ovarian tumors might also benefit from this new method.…”

Cytomorphology of Common Malignant Tumors of the Breast

“…Nucleoli and subtle nuclear membrane irregularities may appear more prominent. Despite these differences in cellular features, diagnostic accuracy is not significantly different between direct smears and liquid-based collection with thin-layer preparation, once one becomes familiar with these differences [7][8][9][10][11].…”

“…Key features include increased cellularity, the presence of single epithelial cells, angular epithelial clusters, and mild to moderate atypia (Figs. [10][11][12]. Dawson and colleagues [31] emphasize that these features often are not the predominate component on the smears.…”

An evaluation of the diagnostic adequacy and immunocytochemistry of manual liquid-based smears in breast aspirates

“…Using the Auto Cyto Fix 1000 ® (ACF, Chiba, Japan) method, Yamashita et al 8 found that a rather inexpensive method of LBC yielded results similar to those of CSC and stated that the problems of low cellularity, air drying and blood in the background could be alleviated using their LBC method.…”