Linda Hastings, Presenter: Nothing to Disclose

Steven David Allen MBBS, Abstract Co-Author: Nothing to Disclose

Ashutosh Nerurkar MD, Abstract Co-Author: Nothing to Disclose

Sue Ashley PhD, Abstract Co-Author: Nothing to Disclose

Gina Brown MD, MBBS, Abstract Co-Author: Nothing to Disclose

In patients with suspected breast malignancy, the availability of immediate diagnostic cytopathology avoids delays in treatment planning. The aim of this study was to determine whether this information could be obtained in a single step procedure using a rolled smear imprint cytology technique from ultrasound-guided core biopsies

This was designed as a single stage phase II study. To show an inadequacy rate of <20% in breast cancer patients with 90% power we required a sample size of 112 biopsies by one Sonographer. Patients were eligible if they presented with a solid suspicious mass requiring ultrasound guided core biopsy. The core biopsy sample was rolled to produce an imprinted cytological sample, the core then placed in a bottle of formalin and both samples sent for histopathological and cytological analysis. C1-C3 from malignancy ( defined on histopathology as B4 B5 ) were classified as false negative.C4/C5 were considered adequate.

112 patients were biopsied. 4 samples yielded C1, 2 C2 and 1 C3 samples were obtained from cancers giving an inadequacy rate of 6.25% (95% CI = 3-12%). Overall there was a 0% false positive rate and 1.7% false negative rate, easily satisfying national guidelines.

Imprint cytology from an ultrasound guided core biopsy provides both a highly accurate pathological diagnosis and immediate cyological diagnosis of a solid breast lump. With a single needle test, the full benefits of a core biopsy are obtained such as the tumor grade and hormone status.  

Imprint cytology at the same time as ultrasound-guided biopsy on suspected breast cancer enables early diagnosis and  treatment planning to be commenced

Hastings, L, Allen, S, Nerurkar, A, Ashley, S, Brown, G, The Value of Ultrasound-guided Imprint Cytology for Rapid Assessment in Symptomatic Breast.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016031.html