Abstract
This study examined cells contained in needles used for the collection of breast fine needle aspirates for the detection of malignant cells trapped in the needles. Remnants of cells contained in 50 needles used for the collection of scanty breast fine needle aspirates were examined by the liquid based cytology technique and compared with the conventional cytological technique of specimens in the corresponding syringes. The breast specimens were collected with clean sterile needles attached to the syringes. Smears were made and stained by the conventional method. The needles were removed from the syringes and a fixative was withdrawn into the syringes and the syringes were recapped with the needles. The fixative containing the specimen was then completely discharged into a centrifuge tube through the needles and treated by the liquid based cytology technique. The study revealed that cells were found trapped in all the needles used for the collection of breast FNA. 6% of them were positive for malignancy, similar to results obtained in the conventional method. Needles used for the collection of breast FNA should be examined before malignancy is completely ruled out particularly in extremely scanty specimens with a clinical suspicion of malignancy.
Highlights
Liquid-based cytology is a technique that enables cells to be suspended in a monolayer and making better morphological assessment possible with improved sensitivity and specificity because fixation is better and nuclear details are well preserved in this technique
Remnants of cells contained in 50 needles used for the collection of scanty breast fine needle aspirates were examined by the liquid based cytology technique and compared with the conventional cytological technique of specimens in the corresponding syringes
The introduction of liquid based cytology has led to improvements in unsatisfactory smear rates, with significant benefits to colposcopic referrals and laboratory turnaround times and colposcopic referrals for repeated unsatisfactory smears has fallen from almost 25% to 0.5%, while the percentage of unsatisfactory smears has fallen from 13.6% to 1.9% [2]
Summary
Liquid-based cytology is a technique that enables cells to be suspended in a monolayer and making better morphological assessment possible with improved sensitivity and specificity because fixation is better and nuclear details are well preserved in this technique. The superiority of the quality of liquid based cytology in comparison with those of conventional smears has been described [3,4]. The sensitivity of a conventional Pap smear is estimated to be 70-80% and about 85-95% for liquid-based cytology tests [5]. Liquid-based cytology was introduced as an improvement of the Pap smear technique for cervical specimens but it has been used for non-gynaecologic cytology [9] and brilliant results have been obtained. The aim of this work was to determine by liquid based cytology the diagnostic value of remnants of cells in needles which are meant to be discarded after the conventional cytological technique for breast specimens
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