J P Bulte1, C A P Wauters2, L E M Duijm3, J H W de Wilt4, L J A Strobbe5. 1. Department of Surgery, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands. Electronic address: jorisbulte@gmail.com. 2. Department of Pathology, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands. 3. Department of Radiology, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands. 4. Department of Surgery, Radboud University Medical Center, Route 618, Postbox 9101, 6500 HB Nijmegen, The Netherlands. 5. Department of Surgery, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands.
Abstract
BACKGROUND: Fine Needle Aspiration Biopsy (FNAB), Core Needle biopsy (CNB) and hybrid techniques including Core Wash Cytology (CWC) are available for same-day diagnosis in breast lesions. In CWC a washing of the biopsy core is processed for a provisional cytological diagnosis, after which the core is processed like a regular CNB. This study focuses on the reliability of CWC in daily practice. METHODS: All consecutive CWC procedures performed in a referral breast centre between May 2009 and May 2012 were reviewed, correlating CWC results with the CNB result, definitive diagnosis after surgical resection and/or follow-up. Symptomatic as well as screen-detected lesions, undergoing CNB were included. RESULTS: 1253 CWC procedures were performed. Definitive histology showed 849 (68%) malignant and 404 (32%) benign lesions. 80% of CWC procedures yielded a conclusive diagnosis: this percentage was higher amongst malignant lesions and lower for benign lesions: 89% and 62% respectively. Sensitivity and specificity of a conclusive CWC result were respectively 98.3% and 90.4%. The eventual incidence of malignancy in the cytological 'atypical' group (5%) was similar to the cytological 'benign' group (6%). CONCLUSION: CWC can be used to make a reliable provisional diagnosis of breast lesions within the hour. The high probability of conclusive results in malignant lesions makes CWC well suited for high risk populations.
BACKGROUND: Fine Needle Aspiration Biopsy (FNAB), Core Needle biopsy (CNB) and hybrid techniques including Core Wash Cytology (CWC) are available for same-day diagnosis in breast lesions. In CWC a washing of the biopsy core is processed for a provisional cytological diagnosis, after which the core is processed like a regular CNB. This study focuses on the reliability of CWC in daily practice. METHODS: All consecutive CWC procedures performed in a referral breast centre between May 2009 and May 2012 were reviewed, correlating CWC results with the CNB result, definitive diagnosis after surgical resection and/or follow-up. Symptomatic as well as screen-detected lesions, undergoing CNB were included. RESULTS: 1253 CWC procedures were performed. Definitive histology showed 849 (68%) malignant and 404 (32%) benign lesions. 80% of CWC procedures yielded a conclusive diagnosis: this percentage was higher amongst malignant lesions and lower for benign lesions: 89% and 62% respectively. Sensitivity and specificity of a conclusive CWC result were respectively 98.3% and 90.4%. The eventual incidence of malignancy in the cytological 'atypical' group (5%) was similar to the cytological 'benign' group (6%). CONCLUSION: CWC can be used to make a reliable provisional diagnosis of breast lesions within the hour. The high probability of conclusive results in malignant lesions makes CWC well suited for high risk populations.
Authors: Joris P Bulte; Altuna Halilovic; Lambert J M Burgers; Coos J M Diepenbroek; Robin A K de la Roij; Ritse M Mann; Marloes van der Leest; Patricia H J van Cleef; Luc J A Strobbe; Johannes H W de Wilt; Peter Bult Journal: Am J Clin Pathol Date: 2020-01-01 Impact factor: 2.493