Fine needle aspiration (FNA) biopsy of palpable breast masses: comparison of conventional smears with the Cyto-Tek MonoPrep system.

Abstract

One of the limitations preventing the widespread use of fine-needle aspiration (FNA) is that it requires skill to obtain an adequate sample and well prepared smears. In this study, a new monolayer technique, the Cyto-Tek MonoPrep (MP) system, which obviates the need for smear preparation, was evaluated against conventional smear (CS) preparation for palpable breast lesions. A total of 44 paired CS/MP breast FNA specimens were studied. The authors blindly analyzed the CS and the MP slides separately, then by a side-by-side evaluation. The two methods were compared with respect to diagnostic concordance, cellularity, cell preservation, background debris, and time needed to prepare and diagnose each case. An exact diagnostic correlation was present in 34 of 44 (77%) cases. The 10 noncorrelating cases were caused by decreased cellularity in the MP cases; nonetheless, 7 of these were correctly assigned to the right general diagnostic category, whereas the remaining 3 cases had insufficient cells. In addition to overall lesser cellularity on MP, fibroadenoma cases had smaller epithelial sheets and absence of stroma compared with CS. Both methods had comparable cellular preservation and diagnostic evaluation time, but background debris and preparation time were greater for MP. CS are favored over MP for the preparation of breast FNA specimens in centers with specialized FNA services because of their higher diagnostic yield, ease of preparation, and availability for immediate cytologic evaluation. However, in settings where specimens are collected sporadically by unskilled clinicians, the MP system may prove to be useful as an alternative or an adjunct to CS. Cancer (Cancer Cytopathol)