Usefulness of intraoperative stump imprint cytology in breast-conserving surgery

Abstract

Objective : Although the detection of a positive margin is widely known to be closely linked to local recurrence of breast cancer in breast-conserving therapy, methods for intraoperatively evaluating resected margins during breast-conserving surgery are not necessarily standardized. In the present study, we investigated the usefulness and drawbacks of intraoperative stump imprint cytology (hereafter, stump cytology), which is used in our departments.
Subjects and methods : Among a total of 308 patients who underwent breast surgery between 2005 and 2007, we investigated 160 patients who underwent breast-conserving surgery as well as stump cytology with regard to their results on stump cytology in addition to permanent tissue samples.
Results : Stump cytology had a sensitivity of 70.0%, specificity of 97.1%, and a diagnostic accuracy of 93.8%. Six false-negative and four false-positive results were obtained. A total of 18 patients had a positive result on stump cytology, while eight patients had cancer based on the permanent tissue samples prepared from additionally resected parts. The directions of positive results on stump cytology were papillary (n=16), lateral (n=5), and opposite the papilla (n=2).
Conclusion : These findings suggest that stump cytology is a simple and useful method for intraoperatively evaluating margins during breast-conserving surgery.