Diagnostic use of mean nuclear area and nuclear DNA content in preoperative breast cancer cytology.
OBJECTIVE
Fine needle aspiration (FNA) cytology of breast lumps is a routine procedure, and the diagnostic accuracy can be 95%. Occasional discrepancies arise, and it would be valuable to have additional parameters for accurate diagnosis. We evaluated nuclear DNA content and mean nuclear area (MNA) using image cytometry in the diagnosis of preoperative breast cancers by FNA in those with a discrepancy between clinical, radiologic and cytologic diagnoses.


METHODS
One hundred eighteen consecutive preoperative FNA samples were evaluated for nuclear DNA and MNA and were compared to cytologic and postoperative histologic diagnoses.


RESULTS
Sensitivity, accuracy and positive predictive value of routine cytology were 95%, 90%, 95% as compared to nuclear DNA (66%, 66%, 96%) and MNA (61%, 61%, 97%). Combining these 3 parameters gave a sensitivity of 97%, accuracy of 94% and positive predictive value of 99%.


CONCLUSIONS
These results demonstrate that nuclear DNA and MNA combined with routine cytology may be useful adjuncts in preoperative breast cancer cytologic diagnosis when discrepancies arise. This may lead to better and more accurate planning of treatment regimens in preoperative breast cancer patients.
Sarker
Sudip K
SK
Imperial College of Science, Technology and Medicine, St. Mary's Campus, University of London, London, U.K. sudip_sarker@hotmail.com
D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology*; D004273:DNA, Neoplasm / Q000032:analysis*; D003952:Diagnostic Imaging / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D042361:Mammary Glands, Human / Q000473:pathology / Q000648:ultrastructure*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity
D004273:DNA, Neoplasm