Touch Imprint Cytology of Core Needle Biopsy Specimen, Integrated with Radiologic Assessment for Rapid Diagnosis of Breast Lesions: A Libyan Single-Center Experience

• Wesam Elsaghayer

  Department of Pathology, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Mohamed Bashagha

  Department of Radiology, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Wafaa Babh

  Department of Pathology, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Misbah Elfagih

  Department of Surgery, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Mohamed Elfagieh

  Department of Surgery, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Esraa Obida

  Department of Pathology, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

• Ebrahim Elmahjoubi

  Department of Pathology, Faculty of Medicine, Alrazi University, Misrata, Libya

  Author

Rapid confirmation of breast lesion adequacy and likely malignancy during image-guided biopsy may shorten diagnostic delay. This study evaluated touch imprint cytology (TIC) prepared from core needle biopsy material and interpreted in conjunction with radiologic assessment. This retrospective single-center study analyzed 253 breast lesions sampled by core needle biopsy. Descriptive clinicoradiologic data were extracted from the archives of Alrazi University Hospitals (Alzuhor and Alhelal Abbad Hospitals). For diagnostic performance analysis, a composite histopathologic reference standard was constructed using excision histology when available and core biopsy histology otherwise. TIC results were dichotomized as malignant/suspicious versus benign for primary analysis, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated with 95% Wilson confidence intervals. The cohort included 253 patients (mean age 45.2 ± 11.6 years; median 45, IQR 38-50). Histopathologic outcome was classifiable in 147 lesions, of which 109 (74.1%) were malignant, and 38 (25.9%) were benign. Among 127 lesions with both a classifiable histopathologic outcome and interpretable TIC result, TIC showed sensitivity 83.9% (95% CI 75.1-90.0), specificity 97.1% (95% CI 85.1-99.5), PPV 98.7% (95% CI 93.2-99.8), NPV 68.8% (95% CI 54.7-80.1), and overall accuracy 87.4% (95% CI 80.5-92.1). Recorded imprint adequacy was high (210/213, 98.6%). Malignancy rates rose with increasing BI-RADS category, reaching 93.8% for BI-RADS 4C and 100% for BI-RADS 5 among lesions with paired histopathology. TIC of core needle biopsy specimens, when interpreted within a radiologic-pathologic framework, provided high specificity and very high PPV for rapid recognition of malignant breast lesions in this Libyan series. The technique appears particularly valuable as a pragmatic adjunct to standard core biopsy workflows where immediate histologic processing or frozen section support is limited.

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