Breast Cancer Fine Needle Aspirates Research Articles

Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression in breast cancer FNA cell blocks and paired histologic specimens: A large retrospective study.

Molecular analysis represents an increasingly important component of the pathologic examination of tumor specimens. Notably, the characterization of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression in breast cancer specimens provides critical prognostic and predictive information. The objective of the current study was to compare the concordance of these markers as determined on fine-needle aspiration (FNA) cell blocks compared with tissue blocks prepared from surgical specimens. A total of 134 cases of breast carcinoma were identified from 2002 through 2014 with both FNA cell blocks (fixed in 10% formalin) and corresponding available tissue blocks and ER, PR, and HER2 were characterized in both specimens. Negative and positive concordances were determined for ER and PR in cell blocks compared with tissue blocks, and for HER2 immunohistochemistry on cell blocks and tissue blocks versus the corresponding reference method, fluorescence in situ hybridization (FISH). Concordance for ER expression evaluated on a cell block compared with the corresponding tissue block was 96.2%. Concordance for PR expression was 77.5%. Overall agreement of HER2 FISH testing between cell blocks and tissue blocks was 96.7%. For both cell blocks and tissue blocks, HER2 expression by immunohistochemistry demonstrated ≥98% positive and negative concordance with the FISH reference method. ER, PR, and HER2 determination on FNA-acquired cell block (fixed exclusively in 10% formalin) showed excellent agreement for ER and HER2 and moderate agreement for PR with the corresponding tissue block. These findings support the equivalency of ER and HER2 evaluation performed on FNA cell blocks compared with surgical tissue blocks. Cancer Cytopathol 2016;124:828-35. © 2016 American Cancer Society.

Abstract P6-05-11: DEPArray™ enables recovery of pure tumor cells from heterogeneous fine needle aspirates for routine downstream NGS analysis

Abstract Introduction: We have previously shown reliability in isolating pure populations of cells from complex tissues using the DEPArray™. Fine Needle Aspiration (FNA) is a quick and simple procedure often performed to make a diagnosis or rule out conditions such as cancer. Although FNA is also used to assess response to treatment, the procedure is often deemed insufficient in yield and purity of tumor cells. Here we provide preliminary results showing 100% efficiency in recovering pure tumor cell populations from FNA samples of patients affected by Metastatic Breast Cancer and known to have low tumor burden (<20%) prior to using the DEPArray™ platform. Method: FNA paraffin embedded sections (50 microns thickness) from metastases originating from breast (n=3) primary tumors were evaluated. Each FFPE curl was processed to yield single cells followed by DEPArray™ sorting based on cytokeratin (Ker), vimentin (Vim) and nuclear staining. The recovered cell populations were directly lysed in the collection tube prior to PCR-based target enrichment for next generation sequencing using Ion AmpliSeq™ CHPv2. Results: DEPArray™ analysis allowed identification of 3 well separated cell populations, including tumor (Ker+/Vim-), stromal (Vim+/Ker) and putative EMT (Ker+/Vim+) cells. Overall, only 21% (4.3% to 42.7% range) of the total (mean of 6335) cells analyzed were of tumor (KER+/Vim-) origin. Groups of pure cells (mean 105 cells, range 15-200) for each population were recovered for sequence analysis. In one breast cancer FNA sample, we observed TP53 LoH but only in the recovered tumor (KER+) cells and not in the unsorted, stromal (VIM+), or EMT (KER+/VIM+) populations. In addition, a PIK3CA missense somatic heterozygous variant was identified in both the tumor and putative EMT populations but not in stromal cells, confirming this as a somatic mutation. Conclusion: DEPArray™ allows resolution of two main limitations associated with FNA samples obtained for genomic analysis: too few target cells and unwanted admixture of normal cells. DEPArray™ allows for phenotypic distinction between the sorted cells prior to recovery; thus, enabling sequence analysis that is suitable for detecting genomic aberrations such as CNVs and LoH, which cannot be evaluated as precisely in an unsorted sample. Clearly, the DEPArray™ platform brings precision to detection, quantification and recovery of pure target cells that are suitable for subsequent downstream molecular analysis that can improve cancer diagnosis and personalized treatment strategies for breast cancer patients. Citation Format: Sero V, Forcato C, Bolognesi C, Buson G, Medoro G, Yazdani M, Blevins A, Manaresi N, Bischoff FZ. DEPArray™ enables recovery of pure tumor cells from heterogeneous fine needle aspirates for routine downstream NGS analysis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-05-11.

Highlights of This Issue

Studies suggest that antioxidant nutrients may reduce cancer and overall mortality risks, but randomized trials often fail to demonstrate survival benefits. Goyal and colleagues evaluated all-cause, cancer, and cardiovascular mortality risks associated with serum antioxidant levels in over 14,000 US adults. The authors report a decrease in cancer and overall mortality risks with higher serum vitamin C levels. In addition, high serum vitamin E levels were also associated with lowered cancer mortality risks. These data support individualized nutrient intervention studies where doses are based on subjects' serum levels.Periareolar fine needle aspiration (FNA) is increasingly used in breast cancer trials for cancer patient assessments. Using 5-aza-2′-deoxycytidine–induced gene expression assays, Bu and colleagues identified DNA methylation markers suitable for use in FNA clinical samples. The authors identified genes that were differentially methylated in clinical breast cancer FNA samples compared to benign FNA samples. These breast DNA methylation markers may have value as breast cancer biomarkers in studies using FNA.Cutaneous melanomas could arise through different pathways according to phenotype, body site, and sun exposure. To test this, Kvaskoff and colleagues ascertained Australian melanoma patients using pathology reports, patient-reported phenotypes, and dermatologist-counted melanocytic nevi and solar keratosis (SK). Compared with trunk melanoma patients, those with head/neck melanomas were less likely to have high nevus counts and patients with head/neck melanoma were more likely to have high SK counts. These findings support that melanomas on the trunk arise through a causal pathway associated with nevus propensity, whereas melanomas on the head/neck arise through a pathway associated with cumulative sun exposure.Adult height has been positively associated with prostate cancer risk. However, the association between adolescence height, birth weight, and prostate cancer remains undetermined. Cook and colleagues assessed these relationships using Copenhagen School Health Records. Height was significantly associated with prostate cancer risk at all ages but height at age 13 years was more important than height at age 7 years. Birth weight was not associated with prostate cancer risk. These findings implicate late childhood, adolescence, and adulthood growth periods as critical exposure windows underlying the association between height and prostate cancer.

Expression of Epidermal Growth Factor Receptor Tyrosine Kinase Family in Fine Needle Aspiration and Permanent Specimens of Invasive Lobular and Ductal Breast Cancers

Recently, the role of HER-2/Neu gene amplification has been enthusiastically investigated in breast cancer. Determining the HER-2/Neu status could be achieved by evaluating either histologic samples or cytologic specimens obtained by Fine Needle Aspiration (FNA). This study aimed at determining the concordance of HER-2/Neu expression in FNA and histologic sections. FNA samples, as well as their corresponding histologic sections of 90 cases with breast cancer were evaluated in Tabriz Sina Teaching Center in a 13-month period of time. The immunohistochemistry was employed for determining the HER-2/Neu amplification for both methods. The concordance rate and agreement were determined between the two methods. Ninety specimens of women with a mean age of 50.93 +/- 10.64 (29-84) years were assessed. There were 84 cases with invasive ductal carcinoma and 6 cases with invasive lobular carcinoma. Lymph nodes were involved in 50 cases and there were vascular and neural involvement in 40 and 35 cases, respectively. Her-2/Neu was not detected in 27 cases (30%) with weak and strong amplifications in 47 (52.2%) and 16 (17.8%) cases of FNA specimens, respectively. Her-2/Neu was not detected in 29 cases (32.2%) with weak and strong amplifications in 42 (46.7%) and 19 (21.1%) cases of histologic specimens, respectively. The concordance rate was 70% between the two methods. The agree ment was statistically significant between the two methods, as well (kappa = 0.51, p < 0.001). HER-2/neu gene amplification can be reliably estimated by immunohistochemistry on breast cancer FNAs and a good correlation has been found between this and results on histological sections.

Epstein-Barr virus (EBV) in fine needle aspirates containing inflammatory breast cancer cells.

Abstract Abstract #3084 BACKGROUND: Inflammatory breast cancer (IBC) is the most aggressive manifestation of primary breast cancer and its clinical presentation and the peculiar geographic distribution have suggested a possible viral etiology. Mouse Mammary Tumor, Human Herpes Virus 8 or Epstein-Barr virus (EBV) may play significant roles in the pathogenesis of the disease and account for the peculiar lymphangiogenic mechanism of growth and disease progression. In particular, EBV late membrane protein (LMP)-1 plays a critical role in tumor invasion lymphangiogenesis. In this study, EBV DNA was measured in each FNA sample from patients with IBC and locally advanced breast cancer (LABC) using real time PCR directed against 5 different targets within the EBV genome.&amp;#x2028; PATIENTS AND METHODS: Sixty-eight fine needle aspirates (FNA) of breast cancer from patients with newly diagnosed IBC (n=18) and LABC (n=50) were examined. The FNA specimens were collected for the pharmacogenomic research program before any systemic therapy started. Median age of subjects was 53 yrs (range: 26-83 yrs). Total DNA was extracted from the FNA using the QIAmp Kit. EBV DNA were detected by quantitative polymerase chain reaction (QPCR) directed at five different targets within the EBV genome (BamH1W, LMP1, EBNA1, LMP2, and BZLF1) that encode products that are highly conserved across all EBV strains and important for viral pathogenesis. DNA extracted from Namalwa cells were used to construct the standard (R2 = 0.993); HL60 cells were used as EBV-negative controls. Data were collected and analyzed by Sequence Detection System software (Applied Biosystems Incorporated, ABI, Foster City, CA).&amp;#x2028; RESULTS: EBV DNA was detected in freshly obtained breast cancer FNA samples using Q-PCR. The Q-PCR assays were sensitive to as low as 1 copy of EBV DNA per reaction. Of 68 breast tumor FNA specimens, EBV genes were detected in FNA from 4/18 (22%) IBC patients (range, 1-4 genes) and 5/50 (10%) LABC patients (range, 1-3 genes). Among the 9 positive specimens, BamH1W was detected in 6; EBNA1 in 5; LMP1 in 4; BZLF1 in 2; and LMP2 in 1, respectively.&amp;#x2028; DISCUSSION AND CONCLUSIONS: Q-PCR is an effective method for detecting EBV DNA in FNA of breast cancer patients. The two most frequently detected EBV DNA sequences were BamH1W (6 of 9) and EBNA1 (5 of 9). BamH1W is a sequence that is frequently replicated throughout the EBV genome and EBNA1 is a reliable latent gene responsible for maintaining infection for life of the host. LMP-1 is a potential viral oncogene and was detected in 4/9 patients. The detection of these EBV sequences suggest latent EBV infections in IBC and LABC patients. The clinical significance of these findings warrants further investigation. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3084.

Chromogenic In Situ Hybridization to Detect HER-2/neu Gene Amplification in Histological and ThinPrep®-Processed Breast Cancer Fine-Needle Aspirates: A Sensitive and Practical Method in the Trastuzumab Era

The increasing evidence of trastuzumab efficacy in breast cancer (BC) patients means that an accurate and reproducible evaluation of HER-2 statusis of paramount importance in histological and in cytological samples. Currently, the two main methods used to analyze HER-2 amplification or overexpression are fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC). Although the two methods are strongly correlated for histological tissue, the evaluation of tumor morphology through FISH may be difficult and fluorescence fades quickly. These limitations can be overcome by chromogenic in situ hybridization (CISH), which can visualize the amplification product along with morphological features. In view of this, in the present study, we analyzed the usefulness of CISH on formalin-fixed, paraffin-embedded (FFPE) BC specimens and investigated whether CISH can be a valid technique in the determination of HER-2 status for fine-needle aspirates (FNAs) processed by liquid-based cytology. The results we obtained in a retrospective series of 111 FFPE BC specimens demonstrated good concordance between CISH and IHC and between CISH and FISH. The former concordance was comparable with that observed between FISH and IHC. When CISH was applied to a prospective series of 53 FNAs, from surgically removed BC, our data showed evidence of a higher concordance of results between liquid-based cytology and the companion FFPE tissues using CISH rather than HercepTesttrade mark. Therefore, CISH analysis, which is avaluable and reproducible alternative to FISH for selecting breast cancer patients for trastuzumab therapy, can lower false-positive immunocytochemistry findings in ThinPrep-processed FNAs.

HER-2/neu Detection in Fine-Needle Aspirates of Breast Cancer

We evaluated HER-2 receptor status by immunocytochemical and immunohistochemical analyses and fluorescence in situ hybridization (FISH) in 51 fine-needle aspiration (FNA) specimens together with the corresponding formalin-fixed, paraffin-embedded (FFPE) tissue samples obtained from surgically resected breast cancers. Three fixation methods were compared: ethanol, formalin, and CytoLyt-ThinPrep (Cytyc, Boxborough, MA). HER-2 was overexpressed and amplified in 8 (16%) of 51 FFPE specimens. Of the 8 cases, gene amplification was observed in 8 FNA specimens (100%) and overexpression in 2 (25%) ethanol-, 4 (50%) CytoLyt-, and 5 (63%) formalin-fixed FNA specimens. Strong pairwise κ association between FISH results performed on FNA specimens and FFPE tissue samples (ethanol fixation, κ = 0.848; ThinPrep, κ = 0.918) and moderate (ThinPrep, κ = 0.692; formalin fixation, κ = 0.667) to poor (ethanol, κ = 0.300) pairwise κ agreement between tissue immunohistochemical and FNA immunocytochemical results was demonstrated. We conclude that HER-2 protein expression on cytologic preparations was insufficiently reliable for clinical use, whereas HER-2 gene amplification determined by FISH demonstrated strong and consistent correlation with HER-2 status of FFPE tissue samples.

HER-2/neu amplification detected by fluorescence in situ hybridization in fine needle aspirates from primary breast cancer

BackgroundThe HER-2/neu gene is amplified in 20–30% of human breast cancers and has been shown to have prognostic and predictive value for treatment with chemotherapy, hormone therapy and antibodies against the HER-2/neu domain (trastuzumab). The aim of our study was to evaluate the reliability of HER-2/neu determination by fluorescence in situ hybridization (FISH) on fine-needle aspirates (FNAs) from primary breast cancer patients by comparison with the results obtained by FISH and immunohistochemistry (IHC) on the corresponding histological sections. Materials and methodsHER-2/neu amplification was determined by FISH on 66 breast cancer FNAs. Twenty-three and 36 corresponding formalin-fixed, paraffin-embedded sections were assayed by FISH and by IHC, respectively, in order to detect HER-2/neu amplification and HER-2/neu protein expression. ResultsTwenty-seven per cent (18/66) of breast cancer FNAs showed amplification of HER-2/neu by FISH. Paired results by FISH cytology and FISH histology were available in 22 cases. Concordance was 91% (20/22). Paired results by FISH cytology and IHC were available in 36 cases. Concordance was 92% (33/36). Eighteen of 66 breast cancer FNAs were also submitted to flow cytometric DNA analysis. None of the diploid cases showed HER-2/neu amplification by FISH. Six out of the eight aneuploid cases were amplified and two were polysomic. ConclusionsHER-2/neu gene amplification can be reliably estimated by FISH on breast cancer FNAs and a good correlation has been found between FISH and IHC results from the corresponding histological sections.

Differential p53 protein expression in breast cancer fine needle aspirates: the potential for in vivo monitoring.

Fine needle aspiration (FNA) biopsy is the least invasive method of sampling breast cancer in vivo and provides material for breast cancer diagnosis. FNA has also been used to examine cellular markers to predict and monitor the effects of therapy. The aim of this study was to assess the accuracy of using FNA material compared with resected cancer for Western blotting studies of the p53 pathway, a key to tumour response to radiotherapy and chemotherapy. Paired samples of breast cancer FNAs collected pre-operatively and post-operatively were compared with tissue samples obtained at the time of surgical resection. Western blots were probed for p53 using the antibodies DO12 and DO1, and for levels of downstream proteins p21/WAF1 and p27. The protein extracted by FNA was sufficient for up to 5 Western blot studies. p53 expression and phosphorylation did not differ significantly pre- and post-operatively, indicating that intra-operative manipulation does not affect p53 expression or downstream activation in breast cancer. However, expression of p53, p21 and p27 varied between individual patients suggesting a range of p53 pathway activation in breast cancer. Immunohistochemistry confirmed that the cancer cells accounted for the protein expression detected on Western blots. FNA yields adequate protein for Western blotting studies and could be used as a method to monitor p53 activity in vivo before and during anti-cancer treatment possibly providing early evidence of tumour response to therapy. © 2001 Cancer Research Campaign http://www.bjcancer.com

Fluorescence in situ hybridisation detection of erbB2 amplification in breast cancer fine needle aspirates.

AIM: To develop a method for the detection of amplification of the erbB2 oncogene in breast cancer fine needle aspirates using fluorescence in situ hybridisation (FISH) and to compare amplification...

PCR amplification of DNA obtained from archived hematoxylin-eosin--and giemsa-stained breast cancer aspirates.

The study of DNA abnormalities in fine-needle aspiration (FNA) specimens for breast cancer could be helpful in improving the capacity of diagnosis and specially to obtain prognostic or predictive information. The aim of the present study was to verify whether it is possible to perform molecular analysis in slides of breast cancer FNA specimens. previously stained by hematoxylineosin (H&E) and Giemsa, stored at least for 3 years. For this purpose, 10 cases of FNA obtained from breast cancer patients diagnosed between 1993 and 1994 in our institute were used. Five cytologic smears were alcohol-fixed and stained with H&E. The other five were air-fixed and Giemsa stained. DNA was isolated from the cytologic smears and amplified by using radioactive polymerase chain reaction (PCR) aimed at BAT-26 marker. Our results demonstrate that archived stained smears prepared for cytologic examinations can be used for molecular analyses by using a PCR amplification method. DNA could be isolated and PCR amplified independently of the prior fixation and staining procedures. So, we conclude that the application of molecular biology techniques to the existing archival smears may become a valuable tool to detect genetic changes in samples from breast cancer aspirates.

PCR amplification of DNA obtained from archived hematoxylin‐eosin– and giemsa‐stained breast cancer aspirates

The study of DNA abnormalities in fine-needle aspiration (FNA) specimens for breast cancer could be helpful in improving the capacity of diagnosis and specially to obtain prognostic or predictive information. The aim of the present study was to verify whether it is possible to perform molecular analysis in slides of breast cancer FNA specimens, previously stained by hematoxylin-eosin (H&E) and Giemsa, stored at least for 3 years. For this purpose, 10 cases of FNA obtained from breast cancer patients diagnosed between 1993 and 1994 in our institute were used. Five cytologic smears were alcohol-fixed and stained with H&E. The other five were air-fixed and Giemsa stained. DNA was isolated from the cytologic smears and amplified by using radioactive polymerase chain reaction (PCR) aimed at BAT-26 marker. Our results demonstrate that archived stained smears prepared for cytologic examinations can be used for molecular analyses by using a PCR amplification method. DNA could be isolated and PCR amplified independently of the prior fixation and staining procedures. So, we conclude that the application of molecular biology techniques to the existing archival smears may become a valuable tool to detect genetic changes in samples from breast cancer aspirates. Diagn. Cytopathol. 1998;19:395–397. © 1998 Wiley-Liss, Inc.

Detection of numerical chromosome 17 abnormalities in fine-needle aspirates of breast cancer using a novel in situ hybridization signal amplification method.

We describe a method of in situ hybridization (ISH) to assess numerical chromosome abnormalities on alcohol-fixed smears obtained by fine-needle aspiration from breast cancer patients, using a commercially available amplification kit to demonstrate numerical chromosome alterations of chromosome 17. In this staining procedure after detection of the biotin-labeled alpha-satellite probe for chromosome 17 with avidin-biotin-peroxidase, we incorporated a signal amplification based on the peroxidase-catalyzed deposition of a biotinylated phenolic compound followed by a secondary reaction with peroxidase. The reactions are revealed by deposition of diaminobenzidine and can be analyzed in an optical microscope, with total preservation of the morphology, allowing a direct morphologic-cytogenetic correlation. A series of 25 cases of aspirates from breast cancer were analyzed with this methodology. Aneusomy was found in 14 cases (56%), whereas 11 (44%) had a normal number of chromosome 17 copies. Polysomy occurred in all aneusome cases except one. We did not find concordance between numerical chromosome abnormalities of chromosome 17 and nuclear grading as well as with the immunoexpression of p53 and c-erbB2 studied in the smears. We conclude that the application of the ISH signal amplification method on alcohol-fixed smears will eliminate the need for fresh material and will provide several advantages, such as improvement of morphological concomitant analysis without the need for a fluorescence microscope; utilization, whenever malignancy is found, without necessity to reaspirate the patient; and adequacy of archival material.

Nuclear DNA content of fine needle aspirates of invasive ductal carcinomas of the breast.

Patients with aggressive breast cancers benefit from chemotherapy prior to surgery. If the biology of the breast cancers were better characterised pre‐operatively, more patients at risk could be offered chemotherapy. We have assessed nuclear DNA content of fine needle aspirates (FNA) of 103 invasive ductal breast cancers and compared this to tumour size, node status and histological grade. Median follow‐up was 18 months so no prognostic studies were made. Diploid and non‐diploid tumours were distributed equally in node negative and positive patients. However non‐diploidy status increased in line with known prognostic markers of tumour size and histological grade. This suggests that ploidy might contribute to the pre‐operative assessment of prognosis. We conclude that nuclear DNA of breast cancer FNAs may be of value in the pre‐operative biological assessment of breast cancer patients.

Typing and grading breast carcinoma on fine-needle aspiration: is this clinically useful information?

The ability of fine-needle aspiration (FNA) to diagnose breast cancer is beyond question. The established role of cytopathology is to maintain a low benign to malignant biopsy ratio by reducing the number of benign lesions excised. Both typing and grading of breast cancers on FNA have received attention in the cytology literature but how this knowledge can influence management has not been fully explored. Recently we described a method for the cytological grading of breast cancer that compares well with the established Bloom and Richardson grades. In this paper we present our experience of 1,387 breast cancer FNAs reported by us with histological verification. We show that cytologically typing and grading breast cancers are valid exercises that can predict the true nature of the neoplasm. This information may assist in the clinical approach to the malignant breast.

Bel‐2 protein in breast cancer cells obtained by fine needle aspiration (FNA): a preliminary report

The bcl-2 protein plays a role in the regulation of programmed cell death (PCD), overriding apoptosis. Its expression has been reported in breast ductal cells, where it is believed to be involved in the hormonal regulation of hyperplasia and involution. To date, bcl-2 gene product has not been investigated on breast cancer FNA. The expression of bcl-2 protein was evaluated using an immunoalkaline phosphatase technique in 54 pre-operative breast cancer aspirates and in paraffin-embedded sections from 20 matched surgical specimens. A high rate of bcl-2 protein expression was found on FNA samples (65%) and on the corresponding tissue sections (60%); there was a nearly absolute concordance in the two specimens, with 19/20 (95%) cases showing a concordant staining. These findings concur with the view that bcl-2 gene is frequently expressed in breast cancer, possibly through a hormonal-dependent pathway.

Analysis of the causes of false negative cytology reports on breast cancer fine needle aspirates

Forty-six (2.9%) false negative reports were recorded among adequate fine needle aspirates from 1609 consecutive histologically proven carcinomas, observed from 1991 to 1993. False negatives were more frequent among younger women (< 40 years = 7.1; 40-49 years = 4.0; 50-59 years = 3.6; 60-69 years = 1.7; > 69 years = 1.5%), lobular invasive subtypes (5.4%), and smaller tumours (pT1a = 4.2; pT1b = 7.6; pT1c = 1.9; pT2 = 2.1; pT3-4 = 1.5%). The latter findings is probably ascribable to better differentiation and less precise sampling of small non-palpable tumours. No significant association was found between the false negative rate and the sampler's or reader's skill and experience. The former finding may be ascribed to the wide use of sonography guided aspiration, even for palpable masses, and the latter to the fact that readers were highly experienced and undergo periodic quality control of individual performance. False negatives were reclassified at reviews as true false negatives, reading errors or inadequates in 27, 11, and eight cases, respectively. The observed findings suggest that in most cases cytological faults were due to the absence of cytological atypia in cells sampled from well differentiated tumours, rather than to misinterpretation or sampling from adjacent normal tissues.

Application of the Scarff-Bloom-Richardson tumor grading system to fine-needle aspirates of the breast.

Assigning a tumor grade to breast cancers provides important prognostic information. This study evaluated the applicability of the Scarff-Bloom-Richardson (SBR) breast cancer grading system to aspiration biopsy cytology. Thirty-five consecutive breast cancer fine-needle aspirates and their surgical specimens were reviewed by two pathologists. An SBR grade of 1-3 was assigned by each pathologist to both the fine-needle aspirate and biopsy specimen, based on the sum of scores given to each of three features: tubular differentiation, nuclear pleomorphism, and mitotic index. Both pathologists assigned the same SBR score to 74.3% of biopsy specimens and 65.7% of fine-needle aspirates. The cytologic grade could be used to predict the histologic grade in as many as 57.1% of cases. The wide disparities in the cytologic and histologic grades in some cases were chiefly due to difficulties in detecting mitoses or tubules in the cytology.

DNA flow cytometry of breast cancer fine needle aspirates

DNA flow cytometry of breast cancer fine needle aspirates