IMPROVED FNA CYTOLOGY RESULTS WITH A NEAR PATIENT DIAGNOSIS SERVICE FOR NONBREAST LESIONS

Aim-To review fine needle aspiration (FNA) cytology from sites other t han the breast a year before and a year after the introduction of a ne ar patient FNA diagnosis (NPFD) service in which the FNA were performe d by a pathologist and reported within a few minutes. Methods-The sett ing was a large hospital in rural New Zealand. The year before the int roduction of the NPFD service was examined retrospectively, and the ye ar after prospectively. The pattern of use and the quality of the resu lts before and after starting the NPFD service were compared. Results- Time taken to report the specimens decreased from a few days to a few minutes. There were statistically significant changes in the following : an increase from 237 to 304 in the number of nonbreast FNA performed , and in particular an increase from 65 to 113 in the number for gener al surgery; an increase in the use of immunolabelled flow cytometry fr om 0 to 19 and cell blocks from 3 to 41; an increase in specificity fr om 53% to 80%; a decrease in the overall inadequacy rate from 29% to 9 %; and a decrease in the inadequacy rate for cancers from 9% to 2%. Th e cost of the non-breast FNA service increased by about pound 9200 a y ear. Conclusions-Starting an NPFD service for sites other than the bre ast greatly reduced the reporting time and produced statistically sign ificant increases in the use of FNA cytology and in the quality of the results.