BREAST CYTOLOGY

• Breast lumps readily accessible.

• Allow sampling by FNA technique.
• Has advantages
- Simple to sample
- Cost effective
- short turn around time.
• Impalpable lesion detected radiologically needs guided FNA.

PALPABLE BREAST LUMP

List of necessary equipment.
1) One 10cc syringe and two 21G needles.
2) Number of slides -3 (2 for smears , 1 as the spreader).
3) Jar with the fixative.
 BREAST CYTOLOGY
FIXATION
- The recommended fixative is 95% ethanol.
- The smear should be immediately fixed in 95% ethanol to prevent any air drying.

STAINS.
- Prefered stain pap stain
- Other stains
- H/E – Alcohol fixed smears.
- Geimsa – Air dried smears.

REPORTING FORMAT
- The format ensure uniformity in reporting breast FNAB samples.
 Breast cytology
BREAST LUMP
Reporting Format
• Specimen ;
- FNAB of breast lump (mention site and when provided mammographic findings and clinical
impression).

* MACROSCOPY ;
- Mention the location of the lesion and the number of aspiration attempted.
- Describe the nature of aspirate where relevant.
- Mention whether the lump disappeared or not after the procedure.

* MICROSCOPY;
- A detailed microscopic description is optional.

* CONCLUSION ;
- Mention the diagnostic category (C1-C5)

* COMMENT;
- Mention any other information that you may wish to communicate to the surgeon.
DIAGNOSTIC CATEGORIES
• To ensure uniformity in reporting of breast FNAB samples the cytopathologists are requested
to adhere to the following categories.
C1 - Non – diagnostic smears (inadequate / unsatisfactory)
C2 - Benign smears .
C3 - Atypical smears ,favour benign.
C4 - Suspicious smears ,favour malignant.
C5 - Malignant.

ASPIRATION FLUID FROM BREAST LESIONS

- All aspirated fluid from cystic breast lesions should be dispatched immediately to the
laboratory.
- In the event of any anticipated delay, the samples should be refrigerated at 4oc .
DIAGNOSTIC CATEGORIES
On receiving the sample the amount and colour of fluid should be noted.
- The fluid should be centrifuged and smear made from deposit.
- These smears should be fixed immediately without delay in 95% ethanol

CYSTIC FLUID FROM BREAST LESION

FORMAT REPORTING
-SPECIMEN
• Cyst fluid breast lesion (mention site)
• Macroscopy
- Describe volume /color of fluid received.
MICROSCOPY
- A detailed microscopic description is optional.
DIAGNOSTIC CATEGORIES
DIAGNOSIS
- Mention the diagnostic category (C1 –C5)
COMMENT
- Mention any other information that you may wish to communicate to the surgeon.

NIPPLE DISCHARGE
REPORTING FORMAT
Specimen
- Nipple discharge (mention side)
- MACROSCOPY
- Colour of the discharge ,mention site of the affected duct if possible.
-
DIAGNOSTIC CATEGORIES
MICROSCOPY

A detailed microscopic description is optional.

DIAGNOSIS
- Mention the diagnosis category (C1 – C5)
COMMENT
- Mention any other information that you may wish to communicate to the surgeon.

BODY FLUID (EXFOLIATIVE CYTOLOGY)

- Pleural and ascetic fluid are the most common fluids encountered in cytology practice.

SAMPLE HANDLING
* Preferably all aspirated fluid should be dispatched immediately to the laboratory.
 DIAGNOSTIC CATEGORIES
• In the event of any anticipated delay the sample should be refrigerated at 4oc.
• If the sample is too large it may be allowed to stand for 1-2 hours preferably at 4oc.
• Smaller sample including the sediment should be dispatched to the laboratory (optional).

LABORATORY
On receiving the samples the amount and the color of the fluid should be noted down.
- The fluid should be fixed should be centrifuged and smears should be made from the deposits.
- These smears should be fixed immediately without delay.
- Ensure that the fixative used to fix the smears is of proper strength.
- The most commonly used stain in our setting is PAP stain for alcohol fixed smears;
- Other stains H/E alcohol fixed smears.
- Gemsa for air dried smear.
REPORTING FORMAT
• Must ensure uniformity of exfoliative cytology samples from the body fluids.
REPORTI NG FORMAT
*SPECIMEN
• Mention type.
* MACROSCOPY
• Mention colour.
* MICROSCOPY
• A detailed microscopic description is optional
* DIAGNOSIS
1. Positive for malignant cells or
2 . Negative for malignant cells
REPORTING FORMAT
• COMMEN;
1. Presence or absence of mesothelial cells.
2. Presence or absence of lymphocytes.
3. Mention any other information that you may wish to communicate to the
surgeon.