Availability of Fine Needle Aspirates for the Assessment of HER2 Gene Amplification in Invasive Breast Cancer Patients / 대한진단검사의학회지

BACKGROUND: FISH and immunohistochemistry (IHC) on formalin-fixed paraffin embedded (FFPE) tissue are currently used in the clinical laboratory to determine HER2 status in invasive breast cancer patients. Since tissue-based methods are relatively time-consuming and have a limitation for standardization of procedure, we evaluated the availability of fine needle aspirates (FNA) for the assessment of HER2 status in invasive breast cancer patients. METHODS: FNA were obtained from 51 invasive breast cancer patients and were submitted for the evaluation of HER2 status. After invasive breast cancer components were ascertained by morphological evaluation, HER2 gene amplification was evaluated by FISH. The results of HER2 FISH on FNA cells were compared with those of both FISH and IHC on corresponding FFPE tissues. FISH results were interpreted by American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines issued in 2007. RESULTS: Of 51 FNA specimens, one was excluded due to an insufficient number of cancer cells for tests. Excluding the cases that showed 'equivocal' results, 47 (98%) out of 48 cases were concordant between the results of FISH on FNA and FISH on corresponding FFPE tissue (kappa, 0.969), and 43 (93%) out of 46 cases were concordant between the results of FISH on FNA and IHC on corresponding FFPE tissue (kappa, 0.912). CONCLUSIONS: An excellent correlation was found between FISH on FNA cells and corresponding FFPE sections. We recommend FNA specimens for more rapid determination of HER2 status by FISH, which will be helpful for patient selection for individualized therapy.

Cytologic Classification of Fibrocystic Disease of the Breast: A Proposal for Use of Cytologic Criteria Grading System / 대한세포병리학회지

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for the needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition. these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.