Diagnostic Accuracy of Imprint Cytology in Determining Margin Positivity in Patients Undergoing Breast Conservation

Abstract

 Objectives: To determine the diagnostic accuracy of imprint cytology in identifying margin positivity in patients undergoing breast-conserving surgery for breast cancer, using histopathology as the gold standard.

Study Design and Setting: This cross-sectional validation study was conducted in the Department of Surgery at Khyber Teaching Hospital, Peshawar

Methodology: A total of 154 women aged 30–80 years diagnosed with malignant breast lumps and undergoing breastconserving surgery were enrolled using non-probability convenience sampling. Imprint cytology was performed intraoperatively by pressing clean glass slides against the resected margins of the lumpectomy specimen. Slides were air-dried, stained with hematoxylin and eosin, and examined microscopically. Final margin status was determined by histopathological examination, which served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of imprint cytology were calculated.

Results: The mean age of participants was 51.15 ± 11.87 years. Imprint cytology demonstrated a sensitivity of 40.8%, specificity of 78.3%, PPV of 61.7%, NPV of 60.7%, and overall diagnostic accuracy of 61.0% in detecting margin positivity. The chi-square test showed a statistically significant association between imprint cytology and histopathology findings (p = 0.010).

Conclusions: Imprint cytology provides a rapid and economical method for intraoperative margin assessment during breastconserving surgery, particularly useful in resource-limited settings. However, its diagnostic reliability is operator-dependent and requires standardization for broader clinical application.