Cytopathology Techniques in Breast Lesion Diagnosis

Cytopathology plays a central role in the initial evaluation and triage of breast lesions, combining minimally invasive sampling with microscopic examination to inform clinical management. Fine-needle aspiration cytology (FNAC) offers rapid, low-cost assessment of palpable and image-detected masses, often serving as a first-line tool in resource-limited settings. Core needle biopsy (CNB) yields larger tissue cores for histological architecture and immunohistochemical studies, enhancing sensitivity and specificity, particularly in indeterminate or high-risk lesions. Advances in cell block preparation allow retrieval of sparse cellular material from FNAC for ancillary studies, bridging the gap between cytology and histology. Liquid-based cytology and standardised reporting systems, such as the Yokohama or NHS Breast Screening categories, seek to harmonise diagnostic thresholds and reduce equivocal results. Integration with imaging (mammography, ultrasound, MRI) and clinical examination underpins the “triple assessment,” which improves diagnostic accuracy and guides the choice of surgical, medical or surveillance pathways. Emerging techniques in digital cytology, machine-learning-augmented image analysis and molecular profiling promise further refinement of risk stratification and personalised management of breast lesions worldwide.

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Cytopathology Techniques in Breast Lesion Diagnosis publication trend

The graph below shows the total number of articles in cytopathology techniques in breast lesion diagnosis across all publications each year (not limited to Nature Index journals).

Technical terms

Fine-needle aspiration cytology (FNAC/FNAB): A minimally invasive procedure that retrieves cells from a breast lesion using a thin needle for cytological examination, offering rapid preliminary diagnosis.

Core needle biopsy (CNB): A percutaneous technique using a larger gauge needle to obtain cylindrical tissue cores, preserving architecture and enabling immunohistochemistry and receptor testing.

Cell block: A method of processing residual cytological material from FNAC into a paraffin block, facilitating histological staining and ancillary studies on scant samples.

Liquid-based cytology: A preparation technique in which aspirated cells are suspended in fixative solution, reducing background artefacts and improving slide uniformity.

Yokohama reporting system: An international classification for breast FNAC that assigns categories (Insufficient, Benign, Atypical, Suspicious, Malignant) linked to pooled risks of malignancy, guiding management decisions.

References

1. A Comparison of the Prognostic Effects of Fine Needle Aspiration and Core Needle Biopsy in Patients with Breast Cancer: A Nationwide Multicenter Prospective Registry. Cancers (2023).
2. Statistical methods for evaluating the fine needle aspiration cytology procedure in breast cancer diagnosis. BMC Medical Research Methodology (2022).
3. The Use of the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy. American Journal of Clinical Pathology (2022).