Evaluation of Accuracy of Intra Operative Imprint Cytology for Detection of Breast Lesions

Abstract

Objective:  To determine the accuracy of imprint cytology as an intraoperative diagnostic procedure for breast lesions with histopathological correlation.

Materials and Methods:  This was a descriptive study on 40 cases of breast lesions comprising of inflammatory, benign & malignant lesions including their margins etc. It was conducted at King Edward Medical University, Lahore in collaboration with all Surgical Departments of Mayo Hospital. Relevant clinical data was recorded in a proforma. Both touch and scrape imprints were prepared from all the lesions and stained with May-Grunwaled Giemsa and Haematoxylin & Eosin stains. The imprints were subsequently compared with histopathology sections.

Results:  When we used atypical cases as negative both touch and scrape imprints gave sensitivity, specificity, positive predictive value, negative predictive value and accuracy at 100%. However when we used cases with atypia as positive, sensitivity and negative predictive value were 100% with both touch and scrape imprints. Specificity, positive predictive value and accuracy were 71%, 86%, 85.5% respectively with touch imprints and 78%, 89%, 89% respectively with scrape imprints. No diagnostic difference was noted between the results of both stains. All the imprints were well correlated with histopathological diagnosis.

Conclusion:  Imprint cytology is an accurate and simple intraoperative method for diagnosing breast lesions. It can provide the surgeons with information regarding immediate clinical and surgical interventions.

Keywords:  Breast lesions, Fibroadenoma, Fibrocystic disease, Histopathology, Imprint Cytology, Malignant, Lobular carci-noma, Phylloides tumor.