Mansour Mehzad
Secretary of the Iranian Society of Clinical Cytology
Title: Intraoperative cytological diagnosis of the breast lesions
Biography
Biography: Mansour Mehzad
Abstract
Although FNA has markedly improved preoperative diagnosis of the breast lesions but in many cases the FNA report is not informative and decisive either due to scant cellularity of smears or sampling from neighbouring tissues of a small tumor even in sonography guided FNAs. In these cases an intraoperative diagnosis is mandatory. For many years frozen section was the only way for this purpose which needs a cryostat and a skilled technician to prepare sections. Unfortunately the price of cryostat apparatus is high and not economic in developing countries. The second procedure using in some laboratories has been imprint cytology during surgery. This method although may be useful for soft tumors such as brain tumors, sarcomas or medullary and mucoid carcinomas of the breast but most of the breast neoplasms are firm and fibrous and impossible to collect enough cells by this method. An alternative method that I have used since 20 years ago is scraping of the fresh breast specimens in order to collect cells. The specimen is cut and the surface of the lesion is cleaned by a dry gauze to remove possible blood and exudates. The cut surface of the lesion is scraped by a sharp scalped blade and several smears are prepared from the material. The smears are fixed in 95% alcohol for 1 minute and stained by rapid H&E method. The microscopic results are called to the operating room and whole procedure lasts in each case approximately 4 minutes. This method for intraoperative diagnosis of the breast lesions is cheap, easily performed, informative, reliable and can be used as an alternative for frozen sections in cases where FNA has not established definitegnosis.The sentinel lymph nodes can be easily diagnosed in the same way