Fine Needle Aspiration Impact on Receptor Analysis

Fine Needle Aspiration Impact on Receptor Analysis 

Whereas quantitative assays for ERP and PRP have repeatedly proved their clinical utility, the increasing use of breast tumor biopsies by fine needle aspiration requires an assay that is able to identify the ERP and PRP in small tissue samples. Immunocytochemical procedures are ideal for this and in Section 11.3 a detailed explanation of this method is given. The fine needle aspiration can be used as an 

There are several major advantages in fine needle aspiration. Aspiration biopsy is a nontraumatic procedure and can be repeated easily. This is important during the course of the disease, since this procedure could be used to plan hormonal therapy in metastatic disease (B14). Also, in metastatic disease one could apply the cytochemical technique to several metastatic lesions and thus obtain information on the receptor status of multiple lesions. This technique also has an advantage over surgical biopsies because some metastatic lesions, such as pleural effusions, ascites, or liver metastases, may not be amenable to surgical biopsy. This was demonstrated (L3) by hormonal receptor determination of pleural effusions using thoracoscopic examinations. 

Several investigators have utilized fine needle aspirates for hormone receptor evaluation using an immunocytochemical method (ERICA Abbott Laboratories, North Chicago, IL) and compared the data with the quantitative values obtained by chemical methods [dextran-coated charcoal (DCC)] for both ERP and PRP. These data are shown in Table 1. There was a variation of 65 to 100% in concordance in the separate studies. The ERP immunocytochemical assay in fine needle aspirates was also compared with the immunochemical assay in biopsies with a concordance of 87% (Rl). The role of the immunocytochemical assay of receptors is primarily in patients in whom surgical biopsies cannot be obtained or fi om whom the surgical specimen is too small. 

Fine needle aspiration has limiting factors. There is a tendency for falsenegative results because of relatively few cells (poor cellularity) in the tumor aspirates, for which an estimation of the proportion of positively stained cells may not be accurate. It has also been shown (Rl) that stroma-rich tumors often yield 

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Fine Needle Aspiration Impact on Receptor Analysis. 198... 

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