title: Liquid-based cytology in fine-needle aspiration of breast lesions: a review.
abstract: OBJECTIVE
  Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies. However, the success of breast FNA is highly dependent on the adequate preparation of cytological conventional smears (CS). The liquid-based cytology (LBC) technique consists of an automated method for preparing thin-layer cytological samples from cell suspensions collected in alcohol-based preservative. LBC is designed to improve CS by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts.
  
  
  METHODS
  We performed a review of the published literature about LBC applied to breast FNA.
  
  
  RESULTS
  LBC preparations of breast aspirates demonstrated better cellular preservation, less cell overlapping and elimination of blood and excessive inflammation compared to CS. Conversely, alterations in architecture and cell morphology as well as loss of myoepithelial cells and stromal elements have been described in LBC specimens, requiring training before applying this technique for diagnosis. Studies have shown a similar accuracy between LBC and CS for the diagnosis of breast lesions. LBC also permits the use of residual material for ancillary tests, which is an important advantage compared to CS.
  
  
  CONCLUSIONS
  LBC can be safely applied to breast FNA, showing a similar diagnostic accuracy to CS.
authors.affiliation: Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, and Department of Pathology, University Health Network, Toronto, Ont., Canada.
authors.forename: Rene
authors.initials: R
authors.lastname: Gerhard
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Schmitt
mesh_terms: D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D013194:Staining and Labeling