title: Modified Core Wash Cytology: A reliable same day biopsy result for breast clinics.
abstract: BACKGROUND
  Fine Needle Aspiration Biopsy (FNAB), Core Needle biopsy (CNB) and hybrid techniques including Core Wash Cytology (CWC) are available for same-day diagnosis in breast lesions. In CWC a washing of the biopsy core is processed for a provisional cytological diagnosis, after which the core is processed like a regular CNB. This study focuses on the reliability of CWC in daily practice.
  
  
  METHODS
  All consecutive CWC procedures performed in a referral breast centre between May 2009 and May 2012 were reviewed, correlating CWC results with the CNB result, definitive diagnosis after surgical resection and/or follow-up. Symptomatic as well as screen-detected lesions, undergoing CNB were included.
  
  
  RESULTS
  1253 CWC procedures were performed. Definitive histology showed 849 (68%) malignant and 404 (32%) benign lesions. 80% of CWC procedures yielded a conclusive diagnosis: this percentage was higher amongst malignant lesions and lower for benign lesions: 89% and 62% respectively. Sensitivity and specificity of a conclusive CWC result were respectively 98.3% and 90.4%. The eventual incidence of malignancy in the cytological 'atypical' group (5%) was similar to the cytological 'benign' group (6%).
  
  
  CONCLUSIONS
  CWC can be used to make a reliable provisional diagnosis of breast lesions within the hour. The high probability of conclusive results in malignant lesions makes CWC well suited for high risk populations.
authors.affiliation: Department of Surgery, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands. Electronic address: jorisbulte@gmail.com.
authors.forename: J P
authors.initials: JP
authors.lastname: Bulte
authors.affiliation: Department of Pathology, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands.
authors.forename: C A P
authors.initials: CA
authors.lastname: Wauters
authors.affiliation: Department of Radiology, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands.
authors.forename: L E M
authors.initials: LE
authors.lastname: Duijm
authors.affiliation: Department of Surgery, Radboud University Medical Center, Route 618, Postbox 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: J H W
authors.initials: JH
authors.lastname: de Wilt
authors.affiliation: Department of Surgery, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB Nijmegen, The Netherlands.
authors.forename: L J A
authors.initials: LJ
authors.lastname: Strobbe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062005:Biopsy, Large-Core Needle / Q000379:methods*; D001941:Breast Diseases / Q000175:diagnosis / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000473:pathology*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology*; D003584:Cytological Techniques; D005260:Female; D018226:Fibroadenoma / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D016217:Ultrasonography, Mammary; D055815:Young Adult
keywords: Biopsy; Breast neoplasms; Cytological techniques; Diagnosis