| Nipple Discharge |
PURPOSE:
To describe collection and transportation methods of nipple
discharge for cytologic evaluation.
Note: For breast cysts, see procedure for aspirated fluids.
PROCEDURE:
1.
Cytology is useful in detecting presence of cancer cells and
determining the nature of breast discharge. Any breast secretion,
besides normal milk, is abnormal.
2.
Fill in pertinent patient information and date of collection. Print the
requested information on the form. Complete the form for specimen
type, date for clinical history and diagnosis.
3.
The preferred method of collection of any nipple discharge or other
breast secretion (not to include palpable masses) is to first cleanse
the area and then by applying pressure around the area collect as
much of the fluid as possible in a Cytolyt container. Cytolyt is a
fixative that creates for easy transportation of the sample and for
preserved specimen integrity. Each area of ulceration and or
drainage should have a separate bottle. Each bottle should be
completely labeled and noted which bottle goes with which area. i.e.
left nipple, right nipple, left breast at 1 o’clock etc.
4.
If cytolyt bottles are not available the specimen may be collected
onto frosted edge slides. Obtain 2 frosted-end slides, an alcohol prep
pad, Cytology spray fixative, cardboard slide holders. These are
available from CAP-LAB. If the collecting office does not have any
form of cytology fixative, DO NOT perform the procedure until proper
fixative is obtained. The lack of fixative can distort the cellularity and
cause an accurate diagnosis to become difficult.
Label the 2 slides with the patient’s full name and specimen source.
Number the slides from 1 and 2.
5.
Wipe nipple surface with the alcohol prep pad to prevent
contamination of the nipple.
6.
Express the secretion by gently compressing the areola area between
the thumb and index finger. Begin vertically, and then rotate in a
clockwise direction to include the entire area. Note on the cytology
form when a specific directional pressure produces a significant
secretion.
7.
The secretion on the nipple is smeared by placing the slide at the
nipple and performing a lengthwise motion.
8.
IMMEDIATELY spray the slide with Cytology fixative to avoid air-
drying. Two sprays per slide are adequate. Hold the spray bottle 6-8
inches from the slide.
9.
Express new secretion for each of the slides. Repeat steps 5-8 for
each slide.
10.
As many slides as possible should be attempted due to findings that
diagnostic cells most often appear on latter slides. The first few
slides often contain degenerated cells.
11.
When the secretion is very scant, the slide can be touched lightly
against the nipple, making an imprint smear.
12.
When the nipple erosion or ulceration is present, physiological saline
can be added to erosion fluid, gently mix with the lesion to exfoliate
cells, and smears made on sterile slides as above.
13.
Allow slides to dry completely before putting into the cardboard slide
holders.
14.
Seal the cardboard holder shut with tape; fold and wrap the Cytology
form around the holders. Secure with a rubber band, place in plastic
bag.
15.
Send specimens to CAP-LAB. 517-372-5520
REFERENCES:
Masukawa, Teru, (1975) Breast Cytology Compendium on
Diagnostic Cytology, 3rd Ed., ASC.
Frost, John H., (1975) Obtaining Cell samples From the Breast –
Manual of Cytotechnology, 4th Ed., ASCP.
To describe collection and transportation methods of nipple
discharge for cytologic evaluation.
Note: For breast cysts, see procedure for aspirated fluids.
PROCEDURE:
1.
Cytology is useful in detecting presence of cancer cells and
determining the nature of breast discharge. Any breast secretion,
besides normal milk, is abnormal.
2.
Fill in pertinent patient information and date of collection. Print the
requested information on the form. Complete the form for specimen
type, date for clinical history and diagnosis.
3.
The preferred method of collection of any nipple discharge or other
breast secretion (not to include palpable masses) is to first cleanse
the area and then by applying pressure around the area collect as
much of the fluid as possible in a Cytolyt container. Cytolyt is a
fixative that creates for easy transportation of the sample and for
preserved specimen integrity. Each area of ulceration and or
drainage should have a separate bottle. Each bottle should be
completely labeled and noted which bottle goes with which area. i.e.
left nipple, right nipple, left breast at 1 o’clock etc.
4.
If cytolyt bottles are not available the specimen may be collected
onto frosted edge slides. Obtain 2 frosted-end slides, an alcohol prep
pad, Cytology spray fixative, cardboard slide holders. These are
available from CAP-LAB. If the collecting office does not have any
form of cytology fixative, DO NOT perform the procedure until proper
fixative is obtained. The lack of fixative can distort the cellularity and
cause an accurate diagnosis to become difficult.
Label the 2 slides with the patient’s full name and specimen source.
Number the slides from 1 and 2.
5.
Wipe nipple surface with the alcohol prep pad to prevent
contamination of the nipple.
6.
Express the secretion by gently compressing the areola area between
the thumb and index finger. Begin vertically, and then rotate in a
clockwise direction to include the entire area. Note on the cytology
form when a specific directional pressure produces a significant
secretion.
7.
The secretion on the nipple is smeared by placing the slide at the
nipple and performing a lengthwise motion.
8.
IMMEDIATELY spray the slide with Cytology fixative to avoid air-
drying. Two sprays per slide are adequate. Hold the spray bottle 6-8
inches from the slide.
9.
Express new secretion for each of the slides. Repeat steps 5-8 for
each slide.
10.
As many slides as possible should be attempted due to findings that
diagnostic cells most often appear on latter slides. The first few
slides often contain degenerated cells.
11.
When the secretion is very scant, the slide can be touched lightly
against the nipple, making an imprint smear.
12.
When the nipple erosion or ulceration is present, physiological saline
can be added to erosion fluid, gently mix with the lesion to exfoliate
cells, and smears made on sterile slides as above.
13.
Allow slides to dry completely before putting into the cardboard slide
holders.
14.
Seal the cardboard holder shut with tape; fold and wrap the Cytology
form around the holders. Secure with a rubber band, place in plastic
bag.
15.
Send specimens to CAP-LAB. 517-372-5520
REFERENCES:
Masukawa, Teru, (1975) Breast Cytology Compendium on
Diagnostic Cytology, 3rd Ed., ASC.
Frost, John H., (1975) Obtaining Cell samples From the Breast –
Manual of Cytotechnology, 4th Ed., ASCP.
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