Utilization of core wash material in the diagnosis of breast lesions by stereotactic needle biopsy

• Published in: Cancer 1998-04, Vol.84 (2), p.98-100
• Main Authors: Lankford, Krista V., Kluskens, Larry, Dowlatshahi, Kambiz, Reddy, Vijaya B., Gattuso, Paolo
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biopsy, Needle - methods; Biopsy, Needle - standards; Breast Neoplasms - diagnosis; Breast Neoplasms - pathology; core needle biopsy; core wash; cytology; Diagnosis, Differential; Female; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; nonpalpable breast lesions; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Sensitivity and Specificity; Time Factors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19980425)84:2<98::AID-CNCR5>3.0.CO;2-9

BACKGROUND Several reports have compared the results of fine‐needle aspiration and stereotactic core needle biopsy in nonpalpable breast lesions. In this study the authors describe a simple method to retrieve cytologic material from a core breast biopsy sample that provides the diagnosis within 1 hour of the procedure. METHODS Two hundred and eleven nonpalpable breast lesions were biopsied. Each core needle biopsy sample was placed in a mesh bag, and the bag and needle notch were washed in CytolytR solution to obtain a monolayer using a commercial ThinPrepR processor. The cytologic diagnoses were divided into four categories: benign, suspicious, malignant, and unsatisfactory, which then were compared with core needle biopsy results. RESULTS Cytology reports of 211 lesions were as follows: 169 lesions (80%) were benign, 16 lesions (7.6%) were suspicious, 11 lesions (5.2%) were malignant, and 15 lesions (7.1%) were unsatisfactory. Core needle biopsy showed 165 of 169 samples (98%) to be benign and 4 to be malignant. Of the 16 suspicious smears, 10 were invasive carcinoma, 2 were in situ lesions, 3 were hyperplasias, and 1 was fibrosis. Of the 11 malignant smears, 10 were confirmed on core needle biopsy and 1 was read as atypia on the first core needle biopsy sample and malignant on a second, separate, follow‐up core needle biopsy. Of the 15 unsatisfactory samples, 14 were found to be benign and 1 was found to be malignant on a separate, follow‐up core needle biopsy. CONCLUSIONS The core wash technique was 85% sensitive and 98% specific for malignancy. Only 7% of specimens were insufficient for diagnosis, and 93% of these were proven to be benign. This technique is useful for immediate (within 1 hour) diagnosis of breast lesions, alleviating patient anxiety and supplementing the diagnostic yield of the core biopsy. Cancer (Cancer Cytopathol) 1998;84:98‐100. © 1998 American Cancer Society. The core wash technique is a simple method to retrieve cytologic material from a core breast biopsy sample that allows for rapid diagnosis at minimal cost.