Norm of Cytologic Study of Breast Cyst
Absence of cells indicating malignancy or infection.
Usage of Cytologic Study of Breast Cyst
Determine if the breast lesion is a mass or a cyst, and determine if malignant cells are present.
Description of Cytologic Study of Breast Cyst
Breast cyst cytology is the microscopic study of the fluid or cells obtained by fine-needle aspiration. The lesion may have been detected by breast examination or mammogram. The fluid is fixed and examined by the cytologist on a microscopic slide. Any cells in the cyst fluid are studied for diagnosis of neoplasm, infective process, and, rarely, tuberculosis of the breast.
Professional Considerations of Cytologic Study of Breast Cyst
Consent form NOT required. See Needle aspiration for procedure-specific risks and contraindications .
- Obtain a 21- or 23-gauge long needle, a 10-mL syringe, sterile 0.9% saline, a red- or marble-topped glass tube or gold seal plastic tube, and a clean jar.
- The client should disrobe above the waist.
- Position the client for comfort and accessibility to the cyst and drape him or her for privacy.
- The aspiration site is identified. The skin is cleansed with an alcohol wipe and allowed to dry.
- The suspect mass is immobilized by one hand while the needle is inserted with the other hand.
- Fluid is aspirated when one draws back on the syringe.
- A fluid drop is placed on a clean slide, and the thin edge of a second slide is used to produce a smear.
- The slide is then fixed immediately in 95% ethyl alcohol in a clean jar.
- If more than a minute amount of fluid has been aspirated, place the remaining fluid in a red- or marble-topped tube.
- If the specimen is minute, rinse the needle with 10 mL of sterile 0.9% saline and place the rinsed material into the tube.
- Label the slide and the aspirate or wash with the client's name, and indicate the specimen source, noting which breast.
- Apply pressure to the aspiration site for a short time.
- Write the pertinent clinical information on the laboratory requisition.
- Send the specimens to the laboratory for immediate evaluation.
Client and Family Teaching
- This is the diagnostic procedure of choice for breast cysts in pregnant women because there are no radiographs or anesthesia required.
- This is a sterile procedure that takes approximately 10 minutes, with minimal discomfort.
- Watch the area for the next 72 hours for redness, drainage, and swelling, and check for temperature >101 degrees F (>38.3 degrees C); report any of these signs to the physician or nurse.
- Results are normally available within 48 hours.
Factors That Affect Results
- Immediate fixation of the smear prevents drying of the sample and distortion of the findings because of contamination.
- Some cytologists prefer specimens that were allowed to dry before being placed in the fixative. These should be specifically labeled because they are stained differently for study.
- An insufficient sample may result when the breast lesion is not penetrated or it contains no fluid.
- Aspiration is an inexpensive screening procedure for evaluating breast lesions. It decreases the necessity of open surgical biopsy to determine a definitive diagnosis.
- This test is more reliable than nipple discharge cytology for ruling out neoplasms.
- Culture of the aspirate is usually obtained for a complete work-up.
- There is no difference in the cytologic yield with a 21-gauge needle as compared with that of a 23-gauge needle.
- Fine-needle aspiration is a sensitive test that must be used only in the context of other diagnostic modalities.