title: Rapid on-site cytologic examination of 1500 breast lesions using the modified Shorr's stain.
abstract: BACKGROUND
  Rapid on-site evaluation (ROSE) cytology enables sample quality assessment in the procedure room and facilitates the process of examination. While its use for mammary lesions in one-stop breast clinics has been reported, its usefulness as a cytologic diagnostic tool has not been fully explored.
  
  
  METHODS
  A total of 1500 examinations of core-needle biopsy imprint/fine-needle aspiration cytology were performed for outpatients with breast lesions. The slides were immediately processed with modified Shorr's stain, which can be completed within a few minutes yet produces specimens of similar staining quality as the Papanicolaou (Pap) stain. The adequacy of sampling was evaluated on site, and a cytologic diagnosis was also made. ROSE cytologic findings were classified into five grades: class 1, inadequate; class 2, benign; class 3, indeterminate; class 4, suspicious for malignancy; class 5, malignant. If enough epithelial cells could not be obtained despite repeated examinations, the sample was scored as ineligible. These scores were utilized for patient management. Final cytologic diagnoses were made with conventional Pap stains.
  
  
  RESULTS
  Reproducibility of scores between both staining methods was excellent (weighted κ statistic = 0.985). When compared class by class, concordance of cytologic diagnoses was particularly high in class 2 and 5 Shorr scores, in which the agreement with Pap diagnoses was 92.8 and 93.6 %, respectively.
  
  
  CONCLUSIONS
  Our modified Shorr's staining protocol was useful to reduce the time for the diagnosis and treatment planning of breast lesions suspected of being breast cancer. It is beneficial for both the patients and clinicians.
authors.affiliation: Department of Diagnostic Pathology, Osaka Rosai Hospital, 1179-3 Nagasone Kita, Sakai, Osaka, 591-8025, Japan, thsakuma@atsumi.jaaikosei.or.jp.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sakuma
authors.forename: Akihiro
authors.initials: A
authors.lastname: Mimura
authors.forename: Naoto
authors.initials: N
authors.lastname: Tanigawa
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Takamizu
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Morishima
authors.forename: Nobuki
authors.initials: N
authors.lastname: Matsunami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D004396:Coloring Agents; D003581:Cytodiagnosis / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D013194:Staining and Labeling / Q000379:methods*; D055815:Young Adult
chemical_list: D004396:Coloring Agents