Abstract
Objective: Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies. However, the success of breast FNA is highly dependent on the adequate preparation of cytological conventional smears (CS). The liquid-based cytology (LBC) technique consists of an automated method for preparing thin-layer cytological samples from cell suspensions collected in alcohol-based preservative. LBC is designed to improve CS by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts. Study Design: We performed a review of the published literature about LBC applied to breast FNA. Results: LBC preparations of breast aspirates demonstrated better cellular preservation, less cell overlapping and elimination of blood and excessive inflammation compared to CS. Conversely, alterations in architecture and cell morphology as well as loss of myoepithelial cells and stromal elements have been described in LBC specimens, requiring training before applying this technique for diagnosis. Studies have shown a similar accuracy between LBC and CS for the diagnosis of breast lesions. LBC also permits the use of residual material for ancillary tests, which is an important advantage compared to CS. Conclusions: LBC can be safely applied to breast FNA, showing a similar diagnostic accuracy to CS.
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References
1.
Kocjan G, Bourgain C, Fassina A, Hagmar B, Herbert A, Kapila K, Kardum-Skelin I, Kloboves-Prevodnik V, Krishnamurthy S, Koutselini H, Majak B, Olszewski W, Onal B, Pohar-Marinšek Z, Shabalova I, Smith J, Tani E, Viehl P, Wiener H, Schenck U, Schmitt F: The role of breast FNAC in diagnosis and clinical management: a survey of current practice. Cytopathology 2008;19:271-278.
[PubMed]
2.
Simsir A, Rapkiewicz A, Cangiarella J: Current utilization of breast FNA in a cytology practice. Diagn Cytopathol 2009;37:140-142.
[PubMed]
3.
Rosa M, Mohammadi A, Masood S: The value of fine needle aspiration biopsy in the diagnosis and prognostic assessment of palpable breast lesions. Diagn Cytopathol 2012;40:26-34.
[PubMed]
4.
Nassar A: Core needle biopsy versus fine needle aspiration biopsy in breast - a historical perspective and opportunities in modern era. Diagn Cytopathol 2011;39:380-388.
[PubMed]
5.
Simsir A, Cangiarella J: Challenging breast lesions: pitfalls and limitations of fine-needle aspiration and the role of core biopsy in specific lesions. Diagn Cytopathol 2012;40:262-272.
[PubMed]
6.
Kurtycz DFI, Hoerl HD: Thin-layer technology: tempered enthusiasm. Diagn Cytopathol 2000;23:1-5.
[PubMed]
7.
Michael CW, Hunter B: Interpretation of fine-needle aspirates processed by the Thin Prep® technique: cytologic artifacts and diagnostic pitfalls. Diagn Cytopathol 2000;23:6-13.
[PubMed]
8.
Cibas ES: Cervical and vaginal cytology; in Cibas ES,Ducatman BS (eds): Cytology: Diagnostic Principles and Clinical Correlates. Philadelphia, Saunders, 2009, pp 1-63.
9.
Hoda RS, Loukeris K, Abdul-Karim FW: Gynecological cytology on convention and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol 2013;41:257-278.
[PubMed]
10.
Leung CS, Chiu B, Bell V: Comparison of ThinPrep and conventional preparations: nongynecologic cytology evaluation. Diagn Cytopathol 1997;16:368-371.
[PubMed]
11.
Dey P, Luthra UK, George J, Zuhairy F, George SS, Haji BI: Comparison of ThinPrep and conventional preparations on fine needle aspiration cytology material. Acta Cytol 2000;44:46-50.
[PubMed]
12.
Veneti S, Daskalopoulou D, Zervoudis S, Papasotiriou E, Ioannidou-Mouzaka L: Liquid-based cytology in breast fine needle aspiration. Comparison with the conventional smear. Acta Cytol 2003;47:188-192.
[PubMed]
13.
Perez-Reyes N, Mulford DK, Rutkowski MA, Logan-Young W, Dawson AE: Breast fine-needle aspiration: a comparison of thin-layer and conventional preparation. Am J Clin Pathol 1994;102:349-353.
[PubMed]
14.
Biscotti CV, Shorie JH, Gramlich TL, Easley KA: ThinPrep versus conventional smear cytologic preparations in analyzing fine-needle aspiration specimens from palpable breast masses. Diagn Cytopathol 1999;21:137-141.
[PubMed]
15.
Feoli F, Ameye L, Van Eeckhout P, Paesmans M, Marra V, Arisio R: Liquid-based cytology of the breast: pitfalls unrecognized before specific liquid-based cytology training - proposal for a modification of the diagnostic criteria. Acta Cytol 2013;57:369-376.
[PubMed]
16.
Ryu HS, Park IA, Park SY, Jung YY, Park SH, Shin HC: A pilot study evaluating liquid-based fine needle aspiration cytology of breast lesions: a cytomorphological comparison of SurePath® liquid-based preparations and conventional smears. Acta Cytol 2013;57:391-399.
[PubMed]
17.
Komatsu K, Nakanishi Y, Seki T, Yoshino A, Fuchinoue F, Amano S, Komatsu A, Sugitani M, Nemoto N: Application of liquid-based preparation to fine needle aspiration cytology in breast cancer. Acta Cytol 2008;52:591-596.
[PubMed]
18.
Nasuti JF, Tam D, Gupta PK: Diagnostic value of liquid-based (ThinPrep) preparations in nongynecologic cases. Diagn Cytopathol 2001;24:137-141.
[PubMed]
19.
Kollur SM, El Hag IA: FNA of breast fibroadenoma: observer variability and review of cytomorphology with cytohistological correlation. Cytopathology 2006;17:239-244.
[PubMed]
20.
Ali AS, Yin D, Yao D, Vazquez M: Criteria for the diagnosis of fibroepithelial lesions of the breast with liquid-based cytology. Acta Cytol 2004;48:481-486.
[PubMed]
21.
Michael CW, Buschmann B: Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology? Cancer Cytopathol 2002;96:92-100.
[PubMed]
22.
Tse GM, Ma TK, Lui PC, Ng W, Yu AM, Vong JS, Niu Y, Chaiwun B, Lam WW, Tan PH: Fine needle aspiration cytology of papillary lesions of the breast: how accurate is the diagnosis? J Clin Pathol 2008;61:945-949.
[PubMed]
23.
Laucirica R, Bentz JS, Khalbuss WE, Clayton AC, Souers RJ, Moriarty AT: Performance characteristics of mucinous (colloid) carcinoma of the breast in fine-needle aspirates: observations from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology. Arch Pathol Lab Med 2011;135:1533-1538.
[PubMed]
24.
Gornstein B, Jacobs T, Bédard Y, Biscotti C, Ducatman B, Layfield L, McKee G, Sneige N, Wang H: Interobserver agreement of a probabilistic approach to reporting breast fine-needle aspirations on ThinPrep®. Diagn Cytopathol 2004;30:389-395.
[PubMed]
25.
Crossley B, Rogers S, Kurien G: Diagnosis of asymptomatic metastatic lobular carcinoma of breast on conventional and liquid-based cervical cytology samples from the same patient. Cytopathology 2014;25:209-210.
[PubMed]
26.
Bėdard YC, Pollett AF: Breast fine-needle aspiration. A comparison of ThinPrep and conventional smears. Am J Clin Pathol 1999;111:523-527.
[PubMed]
27.
Kontzoglou K, Moulakakis KG, Konofaos P, Kyriazi M, Kyroudes A, Karakitsos P: The role of liquid-based cytology in the investigation of breast lesions using fine-needle aspiration: a cytohistopathological evaluation. J Surg Oncol 2005;89:75-78.
[PubMed]
28.
Allred C, Miller K, Viale G: Molecular testing for estrogen receptor, progesterone receptor, and HER; in Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJ (eds): WHO Classification of Tumors of the Breast. Lyon, IARC, 2012, pp 22-23.
29.
Cano G, Milanezi F, Leitão D, Ricardo S, Brito MJ, Schmitt FC: Estimation of hormone receptor status in fine-needle aspirates and paraffin-embedded sections from breast cancer using the novel rabbit monoclonal antibodies SP1 and SP2. Diagn Cytopathol 2003;29:207-2011.
[PubMed]
30.
Skoog L, Tani E: Immunocytochemistry: an indispensable technique in routine cytology. Cytopathology 2011;22:212-229.
[PubMed]
31.
Leung SW, Bėdard YC: Estrogen and progesterone receptor contents in ThinPrep-processed fine-needle aspirates of breast. Am J Clin Pathol 1999;112:50-56.
[PubMed]
32.
Sauer T, Ebeltoft K, Pedersen MK, Kåresen R: Liquid-based material from fine needle aspirates from breast carcinomas offers the possibility of long-time storage without significant loss of immunoreactivity of estrogen and progesterone receptors. Cytojournal 2010;7:24.
[PubMed]
33.
Marinšek ZP, Nolde N, Kardum-Skelin I, Nizzoli R, Onal B, Rezanko T, Tani E, Ostović KT, Viehl P, Schmitt F, Kocjan G: Multinational study of oestrogen and progesterone receptor immunocytochemistry on breast carcinoma fine needle aspirates. Cytopathology 2013;24:7-20.
[PubMed]
34.
Tabbara SO, Sidawy MK, Frost AR, Brosky KR, Coles V, Hecht S, Radcliffe G, Sherman ME: The stability of estrogen and progesterone receptor expression on breast carcinoma cells stored as PreservCyt suspensions and as ThinPrep slides. Cancer Cytopathol 1998;84:355-360.
[PubMed]
35.
Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, van de Vijver M, Wheeler TM, Hayes DF; American Society of Clinical Oncology; College of American Pathologists: American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 2007;25:118-145.
[PubMed]
36.
Beca F, Schmitt F: Growing indication for FNA to study and analyze tumor heterogeneity at metastatic sites. Cancer Cytopathol 2014, Epub ahead of print.
[PubMed]
37.
Beatty BG, Bryant R, Wang W, Ashikaga T, Gibson PC, Leiman G, Weaver DL: HER-2/neu detection in fine-needle aspirates of breast cancer: fluorescence in situ hybridization and immunocytochemical analysis. Am J Clin Pathol 2004;122:246-255.
[PubMed]
38.
Williams SL, Birdsong GG, Cohen C, Siddiqui MT: Immunohistochemical detection of estrogen and progesterone receptor and HER2 expression in breast carcinomas: comparison of cell block and tissue block preparations. Int J Clin Exp Pathol 2009;2:476-480.
[PubMed]
39.
Bėdard YC, Pollett A, Leung SW, O'Malley FP: Assessment of thin-layer breast aspirates for immunocytochemical evaluation of HER2 status. Acta Cytol 2003;47:979-984.
[PubMed]
40.
Shabaik A, Lin G, Peterson M, Hasteh F, Tipps A, Datnow B, Weidner N: Reliability of HER2/neu, estrogen receptor, and progesterone receptor testing by immunohistochemistry on cell block of FNA and serous effusions from patients with primary and metastatic breast carcinoma. Diagn Cytopathol 2011;39:328-332.
[PubMed]
41.
Gorman BK, Kosarac O, Chakraborty, Schwartz MR, Mody DR: Comparison of breast carcinoma prognostic/predictive biomarkers on cell blocks obtained by various methods: Cellient, formalin and thrombin. Acta Cytol 2012;56:289-296.
[PubMed]
42.
Vocaturo A, Novelli F, Benevolo M, Piperno G, Marandino F, Cianciulli AM, Merola R, Donnorso RP, Sperduti I, Buglioni S, Mottolese M: Chromogenic in situ hybridization to detect HER-2/neu gene amplification in histological and ThinPrep-processed breast cancer fine-needle aspirates: a sensitive and practical method in the trastuzumab era. Oncologist 2006;11:878-886.
[PubMed]
43.
Beraki E, Sauer T: Determination of HER-2 status on FNAC material from breast carcinomas using in situ hybridization with dual chromogen visualization with silver enhancement (dual SISH). Cytojournal 2010;7:21.
[PubMed]
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