Abstract
AIM: To review fine needle aspiration (FNA) cytology from sites other than the breast a year before and a year after the introduction of a near patient FNA diagnosis (NPFD) service in which the FNA were performed by a pathologist and reported within a few minutes. METHODS: The setting was a large hospital in rural New Zealand. The year before the introduction of the NPFD service was examined retrospectively, and the year after prospectively. The pattern of use and the quality of the results before and after starting the NPFD service were compared. RESULTS: Time taken to report the specimens decreased from a few days to a few minutes. There were statistically significant changes in the following: an increase from 237 to 304 in the number of non-breast FNA performed, and in particular an increase from 65 to 113 in the number for general surgery; an increase in the use of immunolabelled flow cytometry from 0 to 19 and cell blocks from 3 to 41; an increase in specificity from 53% to 80%; a decrease in the overall inadequacy rate from 29% to 9%; and a decrease in the inadequacy rate for cancers from 9% to 2%. The cost of the non-breast FNA service increased by about 9200 Pounds a year. CONCLUSIONS: Starting an NPFD service for sites other than the breast greatly reduced the reporting time and produced statistically significant increases in the use of FNA cytology and in the quality of the results.
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- Barrows G. H., Anderson T. J., Lamb J. L., Dixon J. M. Fine-needle aspiration of breast cancer. Relationship of clinical factors to cytology results in 689 primary malignancies. Cancer. 1986 Oct 1;58(7):1493–1498. doi: 10.1002/1097-0142(19861001)58:7<1493::aid-cncr2820580720>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
- Brown L. A., Coghill S. B. Cost effectiveness of a fine needle aspiration clinic. Cytopathology. 1992;3(5):275–280. doi: 10.1111/j.1365-2303.1992.tb00048.x. [DOI] [PubMed] [Google Scholar]
- Duguid H. L., Wood R. A., Irving A. D., Preece P. E., Cuschieri A. Needle aspiration of the breast with immediate reporting of material. Br Med J. 1979 Jul 21;2(6183):185–187. doi: 10.1136/bmj.2.6183.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Franzén S., Zajicek J. Aspiration biopsy in diagnosis of palpable lesions of the breast. Critical review of 3479 consecutive biopsies. Acta Radiol Ther Phys Biol. 1968 Aug;7(4):241–262. doi: 10.3109/02841866809133198. [DOI] [PubMed] [Google Scholar]
- Hall T. L., Layfield L. J., Philippe A., Rosenthal D. L. Sources of diagnostic error in fine needle aspiration of the thyroid. Cancer. 1989 Feb 15;63(4):718–725. doi: 10.1002/1097-0142(19890215)63:4<718::aid-cncr2820630420>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
- Kocjan G. Evaluation of the cost effectiveness of establishing a fine needle aspiration cytology clinic in a hospital out-patient department. Cytopathology. 1991;2(1):13–18. doi: 10.1111/j.1365-2303.1991.tb00379.x. [DOI] [PubMed] [Google Scholar]
- Mayall F., Chang B., Darlington A. A review of 50 consecutive cytology cell block preparations in a large general hospital. J Clin Pathol. 1997 Dec;50(12):985–990. doi: 10.1136/jcp.50.12.985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pak H. Y., Yokota S., Teplitz R. L., Shaw S. L., Werner J. L. Rapid staining techniques employed in fine needle aspirations of the lung. Acta Cytol. 1981 Mar-Apr;25(2):178–184. [PubMed] [Google Scholar]
- Rajasekhar A., Sundaram C., Chowdhary T., Charanpal M., Ratnakar K. S. Diagnostic utility of fine-needle sampling without aspiration: a prospective study. Diagn Cytopathol. 1991;7(5):473–476. doi: 10.1002/dc.2840070507. [DOI] [PubMed] [Google Scholar]
- Saleh H. A., Khatib G. Positive economic and diagnostic accuracy impacts of on-site evaluation of fine needle aspiration biopsies by pathologists. Acta Cytol. 1996 Nov-Dec;40(6):1227–1230. doi: 10.1159/000333985. [DOI] [PubMed] [Google Scholar]
- Schultenover S. J., Ramzy I., Page C. P., LeFebre S. M., Cruz A. B., Jr Needle aspiration biopsy: role and limitations in surgical decision making. Am J Clin Pathol. 1984 Oct;82(4):405–410. doi: 10.1093/ajcp/82.4.405. [DOI] [PubMed] [Google Scholar]
- Stanley M. W. Who should perform fine-needle aspiration biopsies? Diagn Cytopathol. 1990;6(3):215–217. doi: 10.1002/dc.2840060314. [DOI] [PubMed] [Google Scholar]
- Winship T. Aspiration biopsy of breast cancers by the pathologist. Am J Clin Pathol. 1969 Oct;52(4):438–440. doi: 10.1093/ajcp/52.4.438. [DOI] [PubMed] [Google Scholar]