Liquid-Based Cytology in Breast Fine Needle Aspiration

OBJECTIVE: To compare the various cytologic features on AutoCyte Prep (ACP) (AutoCyte, Inc., Burlington, North Carolina, U.S.A.) and conventional preparation (CP) specimens from breast fine needle aspiration cytology material with a semi-quantitative scoring system. STUDY DESIGN: A total of 100 randomized cases were studied. In each case, 2 passes were performed. One pass was used for CPs (Giemsa and Papanicolaou stain). The other pass produced material for the ACP technique and Papanicolaou stain. Both the conventional and liquid-based preparations were studied independently by two observers and compared for cellularity, obscuring and/or informing background, representative diagnostic material, preservation of cytomorphologic features, presence of monolayer cells and architectural arrangement. RESULTS: Comparing the two preparations, the results were as follows: (1) ACP was superior to CP in 2 features, lack of obscuring background and presence of monolayer arrangement with preservation of cell architecture; (2) ACP was inferior to CP in 1 feature, lack of informing background; and (3) ACP was equal, with small deviations, to CP in the rest of the features evaluated: cellularity, representative diagnostic material, preservation of cell morphology and architectural arrangement. CONCLUSION: The new technology of liquid-based cytology in breast FNA showed a good correlation with CP plus the advantages of: (1) easier and less time consuming evaluation of cell morphology (clear background, no overlapping, smaller area to screen); (2) reproducibility, a factor of great importance to quality control; and (3) possibility of adjunctive investigations (immunocytology, flow cytometry) on the same material.