Can touch imprint cytology replace fine needle aspiration within current clinical practice?

Introduction

To investigate whether touch imprint cytology (TIC) of needle core biopsy (NCB) is as effective as fine needle aspiration cytology (FNAC) for providing same-day diagnosis of benign and malignant breast lesions at our one-stop symptomatic breast clinic.

Methods

We prospectively studied 426 women with image-detected breast lesions who underwent FNAC and NCB with subsequent TIC. All of the FNAC and TIC samples were sent for immediate reporting. These were read by one of five consultant cytopathologists. The TIC results were subsequently compared with the definitive histopathology from either the core biopsy or the final surgical specimen.

Results

Complete data were present for all patients. TIC was compared with FNAC in providing an accurate and definitive same-day diagnosis in lesions graded C2 (benign) and C5 (malignant). For FNAC, C2 = 75/426 and C5 = 210/426 allowing 66.8% of women a definite same-day diagnosis. For TIC, C2 = 92/426 and C5 = 223/426 allowing 73.8% of women a definite same-day diagnosis. There were no false positive results.

Conclusions

The accuracy of TIC is at least equivalent to FNAC when used as a stand-alone technique for definitive same-day diagnosis from a single biopsy. We therefore conclude that FNAC is no longer necessary, thus saving a second invasive procedure.