Touch-preparation cytologic examination of breast core biopsy specimens: Accuracy in predicting benign or malignant core histologic results

Rationale and Objectives. The purpose of this study was to determine the ac curacy of touch-preparation cytologic examination of breast core biopsy spe cimens in predicting benign or malignant core histologic results. Materials and Methods. One hundred two core biopsies were performed on 88 w omen with stereotactic or ultrasonographic (US) guidance. Slides were prepa red by smearing one core sample on each slide, spraying the slides with fix ative, and staining them with the Papanicolaou technique. Slides were blind ly reviewed by a cytopathologist. Cytologic results were categorized as pos itive for malignancy, not diagnostic for malignancy, or insufficient for di agnosis. Results were correlated with histologic results from all specimens obtained during the core biopsy. Results. Imaging depicted the lesions sampled for biopsy as masses (n = 70) , clustered calcifications (n = 29), focal asymmetries (n = 2), or architec tural distortion (n = 1). Touch-preparation slides of 87 (85%) lesions cont ained sufficient material for diagnosis. Cytologic results correctly identi fied 12 of 16 (three of five intraductal and nine of 11 invasive) malignanc ies in 10 of 13 masses and two of three clusters of calcifications. Two fal se-positive results occurred, both with fibroadenomas. Overall, touch-prepa ration studies produced 69 true-negative and four false-negative results. E xcluding slides with insufficient material, the sensitivity, specificity, a nd accuracy of touch-preparation results were 75%, 97%, and 93%, respective ly. Including insufficient samples, accuracy was 79%. Conclusion. Although touch-preparation cytologic examination of breast core biopsy specimens is fairly accurate in prediction of benign or malignant c ore histologic results, its correlation with histologic results is not suff icient to justify routine use in immediate counseling and treatment plannin g.