Evaluating Field Stain for Rapid On-Site Evaluation in Fine Needle Aspiratinn Cytology of Breast Lesions: Diagnostic Utility with May-Grünwald Giemsa Staining

Introduction: Fine Needle Aspiration (FNA) cytology is a well-established essential, basic diagnostic technique for investigating lumps and lesions at various anatomic sites. While performing FNA of the breast lumps a quick or rapid result is desirable to know the nature of the lump and allay the anxiety of the patient. Rapid On-Site Evaluation (ROSE) is useful to evaluate the cytological smears within a few minutes. This study aims to evaluate the utility of Field’s stain in ROSE of breast lesions in arriving at a diagnosis and its comparison to routine MGG (May Grünwald Giemsa) stain. Materials and methods: This prospective observational study was conducted from July 2023 to December 2023 at a tertiary care center. A total of 89 cases with breast lumps were included. Previously diagnosed cases were excluded. All the cases were evaluated by ROSE using Field’s stain for preliminary diagnosis and compared later with MGG stain for final diagnosis. The categorizaƟon of cases was done as per IAC Yokohama System and further management was advised accordingly. Results: After first and repeat aspiration, 62 (69.6%) cases were categorized as benign, 12 (13.4%) cases were found to be malignant whereas 8 (8.9%), 5 (5.6%), 2 (2.24%) cases were included in the suspicious, atypical and insufficient categories respectively. Categorization of the breast lumps by ROSE using Field stain was in complete agreement with the MGG stained smears and the final FNA diagnosis and showed no discrepancy. Conclusion: The use of Field’s stain for ROSE of breast lumps had comparable staining quality to MGG which resulted in accurate correlaƟon between provisional and final cytologic diagnoses with the added advantage of rapid turnaround Ɵme. Field stain was hence found to be reliable, cost effecƟve and Ɵme saving when used for ROSE of breast lumps. Hence the use of this readily available and affordable stain for ROSE of FNA smears, especially of breast lumps, can prove to be highly beneficial for prompt categorization and triaging of patients. KEYWORDS: Rapid on site evaluation, Breast, Field Stain, Prompt Categorization, Triage