Modified Core Wash Cytology: A reliable same day biopsy result for breast clinics

Eur J Surg Oncol. 2016 Dec;42(12):1821-1826. doi: 10.1016/j.ejso.2016.06.404. Epub 2016 Jul 11.

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.

Keywords: Biopsy; Breast neoplasms; Cytological techniques; Diagnosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Large-Core Needle / methods*
  • Breast Diseases / diagnosis
  • Breast Diseases / pathology
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / pathology*
  • Carcinoma, Ductal, Breast / diagnosis
  • Carcinoma, Ductal, Breast / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating / pathology*
  • Carcinoma, Lobular / diagnosis
  • Carcinoma, Lobular / pathology*
  • Cytological Techniques
  • Female
  • Fibroadenoma / diagnosis
  • Fibroadenoma / pathology*
  • Humans
  • Image-Guided Biopsy
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Time Factors
  • Ultrasonography, Mammary
  • Young Adult