World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website http://www.wjon.org

Original Article

Volume 5, Number 4, August 2014, pages 166-174

Liquid-Based Medium Used to Prepare Cytological Breast Nipple Fluid Improves the Quality of Cellular Samples Automatic Collection

Figures

Figure 1.
Figure 1. HAL breast test equipment.
Figure 2.
Figure 2. Disable silicone cups, “Tulips”, used for collecting fluid samples papillary.
Figure 3.
Figure 3. Vial with liquid to preserve the cellular samples (SurePath™).
Figure 4.
Figure 4. (a) The presence of foam cells, inflammatory cells and cellular debris in basophilic proteinaceous background. (b) The presence of ductal cells with increased nucleus/cytoplasm ratio and hyperchromatism nuclear and acidophilic cytoplasm. Presence of foam cells, mononuclear cells and cellular debris in basophilic proteinaceous background (method 1 - automated Papanicolaou, × 40).
Figure 5.
Figure 5. (a) Ductal cells within the normal range in proteinaceous hyaline background. Absence of interfering cell and cellular debris was observed. (b) The presence of atypical ductal cells with hyperchromatic nuclei, dark chromatin with granular deposit, irregular nuclear membrane, single prominent nucleoli, and a group of cellular overlapped. Cellular clusters, foam cells and mononuclear preserved in hyaline proteinaceous background were observed. Absence of interfering and debris cellular were observed (Zonta & Velame method - Papanicolaou automated, × 40).
Figure 6.
Figure 6. Guideline of clinical practice after aspiration cytology of the mammary papilla.

Tables

Table 1. Demographics and Social Status of Women Included in the Study
 
Group I (159 women)Group II (130 women)
Age20 - 8520 - 85
Breast feeding
  Yes112 (70.44%)112 (86.16%)
  No47 (29.56%)18 (13.84%)
Family history of breast disease
  Yes99 (62.27%)31 (23.84%)
  No60 (37.73%)99 (76.16%)
Nipple discharge
  Yes67 (42.14%)33 (25.39%)
  No92 (57.86%)97 (74.61%)
History of breast disease
  Yes5 (3.15%)31 (23.85%)
  No154 (96.85%)99 (76.15%)

 

Table 2. Methods Used for Obtaining Cellular Material for Cytological Analysis
 
Method 1Method 2 (modified by Zonta & Velame)
Preserved mediumMethanol 8%SurePath ethanol-based medium
Technical procedure1 mL of sample fluid2 mL of sample fluid
Vortex 15 s/3,000 rpmVortex 15 s/3,000 rpm
10 min at 800 g10 min at 800 g
Cells pelletCells pellet
1 mL of Tris buffer (Sigma)1 mL of Tris buffer (Sigma)
1 mL of homogeneous cells pellet1 mL of homogeneous cells pellet
10 m slyde fixing20 m slyde fixing

 

Table 3. Cytological Classification for Breast Screening Program
 
National Statistics and The National Health Service Breast Screening Programme (NHSBSP)
Class 0Unsatisfactory material: absence of cells
Class IINegative for malignancy
Class IIIIndeterminate for malignancy
Class IVSuspicious for malignancy
Class VPositive for malignancy

 

Table 4. Nipple Fluid Samples Collected in an Alcoholic Medium and Subjected to Manual Preparation and Stained by Automated Papanicolaou Method
 
Cellular changesFrequency (%)
Unsatisfactory199 (65.0%)
Benign cells - class II104 (34.0%)
Atypical cells - class III3 (1.0%)
Total306 (100%)

 

Table 5. Cell Samples Prepared by the Automated Method (Zonta & Velame) and Stained by Automated Papanicolaou Method
 
Cellular changesFrequency (%)
Unsatisfactory - class 0127 (49.0%)
Benign cells - class II124 (48.0%)
Atypical cells - class III7 (3.0%)
Total258 (100%)

 

Table 6. Frequency of Benign and Atypical Lesions in Women Evaluated by Method 1 (306 Sample, 100%)
 
Women age (method 1)Unsatisfactory (%)Benign cells (%)Atypical cells (%)
Class 0Class IIClass III
20 - 255 (1.63%)3 (0.98%)0 (0%)
26 - 3510 (3.27%)8 (2.61%)0 (0%)
36 - 4549 (16.01%)12 (3.92%)0 (0%)
46 - 5585 (27.78%)61 (19.93%)1 (0.33%)
56 - 6541 (13.40%)13 (4.25%)1 (0.33%)
66 - 758 (2.61%)4 (1.31%)1 (0.33%)
76 - 851 (0.33%)3 (0.98%)0 (0%)
Total of samples199 (65.03%)104 (33.98%)3 (0.99%)

 

Table 7. The Frequency of Benign and Atypical Lesions in Women Evaluated With Method 2
 
Women age (method 2)Unsatisfactory (%)Benign cells (%)Atypical cells (%)
Class 0Class IIClass III
20 - 256 (2.32%)4 (1.55%)0 (0%)
26 - 3515 (5.81%)14 (5.43%)1 (0.39%)
36 - 4527 (10.46%)32 (12.40%)3 (1.16%)
46 - 5545 (17.44%)37 (13.34%)2 (0.77%)
56 - 6513 (5.04%)25 (9.69%)0 (0%)
66 - 7512 (4.65%)6 (2.32%)0 (0%)
76 - 859 (3.49%)6 (2.32%)1 (0.39%)
Total of samples127 (49.17%)124 (48.05%)7 (2.71%)
Total258 (100%)