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Touch Preparation Cytology of Breast Lumpectomy Margins With Histologic Correlation

Touch Preparation Cytology of Breast Lumpectomy Margins With Histologic Correlation Abstract • Residual microscopic disease after lumpectomy for breast cancer may cause significant local recurrence. We evaluated one hundred fourteen consecutive breast lumpectomy margins in this study by touch preparation cytology. Cytologic preparations were intraoperatively correlated with gross and frozen section results and subsequently with permanent histologic sections of representative margins. Three specimens were cytologically unsatisfactory and 86 yielded benign findings, while material suggestive or diagnostic of malignancy was obtained from 25 specimens. Gross, frozen section, and permanent histologic margins were positive in 10, 17, and 22 cases, respectively. There were three false-positive touch preparation cytologic results, while frozen section specimens were false-negative in five cases. Sensitivity and specificity of touch preparation cytology were 100% and 96.6%, respectively, with a diagnostic accuracy of 97.3%. Touch preparation cytologic examination rapidly and reliably evaluates lumpectomy margins and overcomes sampling errors and artifacts related to frozen section evaluation. This technique currently complements frozen section evaluation of lumpectomy margins as part of a protocol aimed at reducing local recurrence of breast cancer. (Arch Surg. 1991;126:490-493) References 1. Fisher B, Redmond C, Poisson R, Margolese R, et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer . N Engl J Med . 1989;320:822-828.Crossref 2. Harris JR, Connolly JL, Schnitt SJ, et al. The use of pathologic features in selecting the extent of surgical resection necessary for breast cancer patients by primary radiation therapy . Ann Surg . 1985;201:164-169.Crossref 3. Silva EG, Kraemer BB. The examination of margins of resection by frozen section . Surg Pathol . 1988;1:303-306. 4. Carter D. Margins of 'lumpectomy' for breast cancer . Hum Pathol . 1986;17:330-332.Crossref 5. Fisher ER, Sass R, Fisher B, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol 6), II: relationship of local breast recurrence to multicentricity . Cancer . 1986;57:1717-1724.Crossref 6. Gal R. Scrape cytology assessment of margins of lumpectomy specimens in breast cancer . Acta Cytol . 1988;32:838-839. 7. Shidham VB, Dravid NV, Grover S, Kher AV. Role of scrape cytology in rapid intraoperative diagnosis . Acta Cytol . 1976;20:553-555. 8. Lagios MD, Richards VE, Rose MR, Yee E. Segmental mastectomy without radiotherapy . Cancer . 1983;52:2173-2179.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Touch Preparation Cytology of Breast Lumpectomy Margins With Histologic Correlation

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1991.01410280094014
Publisher site
See Article on Publisher Site

Abstract

Abstract • Residual microscopic disease after lumpectomy for breast cancer may cause significant local recurrence. We evaluated one hundred fourteen consecutive breast lumpectomy margins in this study by touch preparation cytology. Cytologic preparations were intraoperatively correlated with gross and frozen section results and subsequently with permanent histologic sections of representative margins. Three specimens were cytologically unsatisfactory and 86 yielded benign findings, while material suggestive or diagnostic of malignancy was obtained from 25 specimens. Gross, frozen section, and permanent histologic margins were positive in 10, 17, and 22 cases, respectively. There were three false-positive touch preparation cytologic results, while frozen section specimens were false-negative in five cases. Sensitivity and specificity of touch preparation cytology were 100% and 96.6%, respectively, with a diagnostic accuracy of 97.3%. Touch preparation cytologic examination rapidly and reliably evaluates lumpectomy margins and overcomes sampling errors and artifacts related to frozen section evaluation. This technique currently complements frozen section evaluation of lumpectomy margins as part of a protocol aimed at reducing local recurrence of breast cancer. (Arch Surg. 1991;126:490-493) References 1. Fisher B, Redmond C, Poisson R, Margolese R, et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer . N Engl J Med . 1989;320:822-828.Crossref 2. Harris JR, Connolly JL, Schnitt SJ, et al. The use of pathologic features in selecting the extent of surgical resection necessary for breast cancer patients by primary radiation therapy . Ann Surg . 1985;201:164-169.Crossref 3. Silva EG, Kraemer BB. The examination of margins of resection by frozen section . Surg Pathol . 1988;1:303-306. 4. Carter D. Margins of 'lumpectomy' for breast cancer . Hum Pathol . 1986;17:330-332.Crossref 5. Fisher ER, Sass R, Fisher B, et al. Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol 6), II: relationship of local breast recurrence to multicentricity . Cancer . 1986;57:1717-1724.Crossref 6. Gal R. Scrape cytology assessment of margins of lumpectomy specimens in breast cancer . Acta Cytol . 1988;32:838-839. 7. Shidham VB, Dravid NV, Grover S, Kher AV. Role of scrape cytology in rapid intraoperative diagnosis . Acta Cytol . 1976;20:553-555. 8. Lagios MD, Richards VE, Rose MR, Yee E. Segmental mastectomy without radiotherapy . Cancer . 1983;52:2173-2179.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Apr 1, 1991

References