Professional paper
https://doi.org/10.24141/1/4/1/8
The importance of intraoperative touch smears cytology in the nipple sparing mastectomy
Petra Dupčić
orcid.org/0000-0002-4282-5962
; University of Applied Health Sciences, Zagreb, Croatia
Karmen Trutin Ostović
; University Hospital Dubrava, MIAC Centre of Clinical Cytology and Cytometry, Zagreb, Croatia
Rado Žic
; University Hospital Dubrava, Department of Plastic, Reconstructive and Aesthetic Surgery, Zagreb, Croatia
Zdenko Stanec
; University Hospital Dubrava, Department of Plastic, Reconstructive and Aesthetic Surgery, Zagreb, Croatia
Smiljka Lambaša
; University Hospital Dubrava, Department of Pathology, Zagreb, Croatia
Abstract
Breast cancer is one of the most widespread malignant tumours in women, more commonly of ductal than lobular origin. It also has the highest incidence and mortality rates. Early detection is very important since breast cancer diagnosis in the initial stages guarantees better outcomes. There are many diagnostic methods. Ultrasound-guided cytological puncture and core biopsy have a major role in early detection of this disease and better chances of survival. A large number of patients had breast-conserving surgery thanks to the early detection of cancer. Mastectomy is usually performed on patients with multicentric, large or recurrent tumours after conservative treatment. Sometimes skin-sparing and nipple-sparing mastectomy is performed on patients with positive BRCA-1 and BRCA-2 genes. Tumour cells can be detected in the nipple in 5-10% of patients with breast cancer. Intraoperative cytologic analysis of
the nipple-areola complex imprint is very important and the accuracy depends on the properly marked part of the nipple (the most important step is to properly label the inner and outer surface of the nipple) and the skill of the cytologist. Over the course of one year, from 9 November 2010 to 10 November 2011, 47 patients had nipple-sparing mastectomy. The comparison of the cytologic and final histopathological diagnosis showed that cytological diagnosis had 97% specificity, 85% sensitivity and 91% diagnostic accuracy. We need to exercise caution in the interpretation of results due to cracks in frozen urgent histopathological cuts and the grouping tendency of malignant cells, as well as necrotic cytologic imprints which can contain hidden and destroyed malignant cells. Intraoperative analysis allows for breast reconstruction during the same surgical procedure.
Keywords
nipple (mamilla mammae); mastectomy; intraoperative cytologic imprint; final histopathological diagnosis
Hrčak ID:
199775
URI
Publication date:
27.4.2018.
Visits: 2.187 *