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An audit of cytology in the evaluation of nipple discharge: A retrospective study of 10 years' experience

Lookup NU author(s): Dr Ashley Groves, Dr Mary Carr, Professor Thomas Lennard

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Abstract

A retrospective analysis of cytology records for 10 years - up to June 1992 - identified 338 assessments of smears from nipple discharges. Cytology reports were located for 329 of the cases, 244 (74%) of which came from boast clinics at two Newcastle teaching hospitals. One clinic (184 smears) assesses all discharges cytologically, the other (60 smears) only those with a history of blood staining. Case notes were obtained for 216 cases (88.5%) enabling the cytology report to be compared with the final clinical or histological diagnosis. Of the 216, 174 (80.6%) were negative with respect to carcinoma and papilloma. Cytology identified 7 confirmed carcinomas and 1 false positive; 8 additional carcinomas were not detected. One papilloma was correctly identified by cytology; there were 12 false positives and 13 false negatives. The overall incidence of carcinoma was 6.9% and of papilloma 6.5%. Regarding carcinoma, cytology heel a sensitivity of 46.5% and specificity of 99.5%. For papilloma, the sensitivity was 7% and the specificity 93.5%. In this series, only 7/15 carcinomas and 1/14 papillomas were identified by discharge cytology. Furthermore, the single false positive for carcinoma assumes major significance when the implications of this diagnosis are considered. Cytology of smears from nipple discharges is simple and non-invasive. Although its use is justified, it is not safe to use cytology as the sole modality of investigation of nipple discharge.

Publication metadata

Author(s): Groves A, Carr M, Wadhera V, Lennard TWJ

Publication type: Article

Publication status: Published

Journal: Breast

Year: 1996

Volume: 5

Issue: 2

Pages: 96-99

Print publication date: 01/01/1996

ISSN (print): 0960-9776

ISSN (electronic): 1532-3080

URL: http://dx.doi.org/10.1016/S0960-9776(96)90129-0

DOI: 10.1016/S0960-9776(96)90129-0

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