A Study to Evaluate the Intraoperative Imprint Smears of Breast Tumours with Histologic Correlation

Jeslin, J (2016) A Study to Evaluate the Intraoperative Imprint Smears of Breast Tumours with Histologic Correlation. Masters thesis, Kilpauk Medical College, Chennai.


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BACKGROUND: India is experiencing an unprecedented rise in the incidence of breast cancer as all other countries. Since there is no preventive measures for breast cancer, it is necessary to detect it early and treat adequately to achieve a longer survival. FNAC is a widely accepted diagnostic tool. Many times FNAC diagnosis is suspicious but not confirmatory, which put the surgeons in to a clinical dilemma. And also risk of over treatment that is mastectomy could be done on the ground of false positive diagnosis. Hence the need for intra-operative confirmation of the condition of the tumour to make a therapeutic decision, led to the development of frozen section technique and imprint smear cytology. Subsequently, the imprint cytology correlated well with the histopathology highlighting its utility as simple, rapid, and easy test. OBJECTIVE: • To evaluate the accuracy of intra-operative imprint smears in breast tumors. • To calculate the sensitivity and specificity of imprint smear in breast tumors. • To correlate imprint smear with histopathological findings. MATERIALS AND METHODS: To evaluate the accuracy of intra operative imprint smear cytology a study was carried out in 50 patients admitted in our hospital as per inclusion and exclusion criteria. Imprint smears were taken intra operatively and were compared with the histopathological examination. RESULTS: The results obtained are listed below: Sensitivity of the test was 95.23 % and specificity was 100 %. The overall diagnostic accuracy was 98.03 %. The positive predictive value was 100 % and negative predictive value was 96.77%. The accuracy rate for benign lesions was 100 % and for malignant lesions was 95.23% False positivity 0 %. False negativity 4.76 %. CONCLUSION: Whenever FNAC reports are inconclusive, intra operative imprint smear aids in the diagnosis of the nature of the tumour and avoids repeat surgeries. It also helps in making decisions in breast conservation surgeries in evaluation of tumour margins. It aids in taking decisions regarding axillary node dissection in the same sitting by assessing the sentinel lymph node status. Recently immunohistochemistry and DNA markers are also being evaluated intra operatively in imprint smears.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Breast tumours ; intra-operative diagnosis ; imprint smear cytology.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 12 Oct 2017 00:48
Last Modified: 12 Oct 2017 00:48
URI: http://repository-tnmgrmu.ac.in/id/eprint/3530

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