Fine needle aspiration versus touch imprint cytology in ultrasound-guided core of breast masses

Introduction

The aim of this study was to compare the results of fine needle aspiration (FNAC, current practice) with imprint cytology (CIC) from ultrasound-guided cores taken in the one-stop clinic setting. CIC allows same-day results with one biopsy procedure. Literature suggests CIC provides a higher sensitivity/C5 rate, although there are few direct comparisons of CIC with FNAC.

Methods

From October 2009 to April 2010, wherever possible, CIC was performed in patients undergoing both ultrasound-guided FNAC and core biopsy. CIC slides were independently reported blind to FNA results. Results were compared with core biopsy histology and therapeutic excision histology, when available.

Results

The cases included 90 female patients with 93 masses (54 malignant, 39 benign masses based on final histology). In the malignant group the C5 rate was 61% (33/54) for FNAC, 83% (45/54) for CIC and 85% (46/54) for the combination of FNA and CIC. No cancers in this sample had an initially benign core result with malignant FNA or CIC result. In the benign group the C2 rate was 41% (16/39) for FNA, 69% (27/39) for CIC, and 64% (25/39) for the combination of FNA and CIC. There were no false positive C5 results. Imprints were easy to perform and there was no damage to the core biopsy material. Cytologists encountered no problems interpreting CIC.

Conclusions

The use of CIC in ultrasound-guided core biopsies in place of conventional FNAC has been validated by this study. No significant obstacle to adopting core imprint cytology has been identified.