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Cited by 6Breast Lesions and CarcinomasAI in cancer detectionLymphadenopathy Diagnosis and Analysis

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Rapid Onsite Evaluation for Specimen Adequacy and Triage of Breast Masses in a Low-Resource Setting

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Kimambo, Asteria H., Vuhahula, Edda A., Philipo, Godfrey S., Mushi, Beatrice P., Mmbaga, Elia J., Van Loon, Katherine, Ng, Dianna L.·2024·Archives of Pathology & Laboratory Medicine
DOI 10.5858/arpa.2022-0398-oaPMC PMC10728347
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Abstract

Context.—: Rapid onsite evaluation (ROSE) is critical in determining sample adequacy and triaging cytology samples. Although fine-needle aspiration biopsy (FNAB) is the primary method of initial tissue sampling in Tanzania, ROSE is not practiced. Objective.—: To investigate the performance of ROSE in determining cellular adequacy and providing preliminary diagnoses in breast FNAB in a low-resource setting. Design.—: Patients with breast masses were recruited prospectively from the FNAB clinic at Muhimbili National Hospital. Each FNAB was evaluated by ROSE for overall specimen adequacy, cellularity, and preliminary diagnosis. The preliminary interpretation was compared to the final cytologic diagnosis and histologic diagnosis, when available. Results.—: Fifty FNAB cases were evaluated, and all were adequate for diagnosis on ROSE and final interpretation. Overall percentage of agreement (OPA) between preliminary and final cytologic diagnosis was 84%, positive percentage of agreement (PPA) was 33%, and negative percentage of agreement (NPA) was 100% (κ = 0.4, P < .001). Twenty-one cases had correlating surgical resections. OPA between preliminary cytologic and histologic diagnoses was 67%, PPA was 22%, and NPA was 100% (κ = 0.2, P = .09). OPA between final cytologic and histologic diagnoses was 95%, PPA was 89%, and NPA was 100% (κ = 0.9, P = <.001). Conclusions.—: False-positive rates of ROSE diagnoses for breast FNAB are low. While preliminary cytologic diagnoses had a high false-negative rate, final cytologic diagnoses had overall high concordance with histologic diagnoses. Therefore, the role of ROSE for preliminary diagnosis should be considered carefully in low-resource settings, and it may need to be paired with additional interventions to improve pathologic diagnosis.

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Metadata

Authors
Kimambo, A. H., Vuhahula, E. A., Philipo, G. S., Mushi, B. P., Mmbaga, E. J., Van Loon, K., & Ng, D. L.
Affiliations
  • Muhimbili University of Health and Allied Sciences (TZ)
  • the Division of Hematology and Oncology in the Department of Medicine (Van Loon), the Helen Diller Family Comprehensive Cancer Center (Van Loon, Ng)
  • Memorial Sloan Kettering Cancer Center (US)
Corresponding author
Ng, Dianna L.
ORCID
Venue
Archives of Pathology & Laboratory Medicine
Publisher
Archives of Pathology and Laboratory Medicine
Published
2023-06-19
Volume
148
Issue
1
Pages
e9-e17
ISSN
  • 0003-9985 (ISSN-L)
  • 1543-2165
DOI
10.5858/arpa.2022-0398-oa
PMC
PMC10728347
OpenAlex
W4380925291
Cited by
6
References
2
Citations by year
2026: 4 · 2024: 2
FWCI
1.19
Type
journal article
Language
en
Open access
Locations
  • Archives of Pathology & Laboratory Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR001873, UL1TR002384)
  • National Cancer Institute (P30CA008748, K08CA263299)
  • Fogarty International Center (D43TW009343, D43TW011598)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphadenopathy Diagnosis and Analysis
Keywords
rapid on-site evaluation, breast mass, fine-needle aspiration, specimen adequacy, resource-limited settings, Tanzania
MeSH terms
Breast, Humans, Tanzania, Triage, Biopsy, Fine-Needle

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