FINE-NEEDLE ASPIRATION TECHNIQUE FOR THE CONCURRENT IMMUNOCYTOCHEMICAL EVALUATION OF MULTIPLE BIOLOGIC PARAMETERS IN PRIMARY BREAST-CARCINOMA

Fine-needle aspiration cytology has been already established as a reli able method for the diagnosis of breast cancer. Its application has be en recently extended to immunocytochemical analysis of biological para meters. In the current study estrogen and progesterone receptors, Ki67 growth fraction, and p53 protein expression were immunocytochemically evaluated on the cellular material sampled by the same fine-needle as pirate used for the conventional cytologic diagnosis of malignancy. Fi ne-needle aspiration specimens from 100 patients with primary breast c arcinoma were submitted to the immunocytochemical analysis. Twenty-eig ht percent were in premenopause; 23% had tumors with a diameter less t han 2 cm, 59% from 2 to 5 cm, and 18% more than 5 cm; 60% had axillary nodal status negative, 34% positive, and 6% unknown. The concomitant immunocytochemical evaluation of all parameters was possible in 70% of the patients. A significant association was found between p53 overexp ression and Ki67 values (p = 0.004), and between Ki67 values and proge sterone receptor status (p = 0.003). No correlation was found between any parameter and clinical tumor size. Estrogen (p = 0.02) and progest erone (p = 0.04) receptor negativity and high Ki67 growth fraction (p = 0.005) were significantly associated with the clinical evidence of a xillary node involvement. This study suggests that fine-needle aspirat ion cytology represents an effective practice for a simultaneous evalu ation of multiple biologic indicators and could be useful as a preoper ative procedure in patients who are candidates for neoadjuvant chemoth erapy and/or endocrine therapy.