Diagnostic concordance of telecytology and conventional cytology for evaluating breast aspirates

OBJECTIVE: To evaluate the diagnostic concordance between static electronic images versus glass slides for breast fine needle aspiration (FNA) cytology. STUDY DESIGN: Nine malignant and 12 benign breast FNA cases were imaged using the Roche Image Manager, at a resolution of 1,024x768 pixels. A cytotechnologist or pathology resident selected five to nine representative images per case. Case histories and images were assembled into hypertext documents. Two pathologists blindly made diagnoses for each case based on the images and the clinical history and independently made diagnoses for the glass slides, also evaluating each set of images and glass slides for a list of cellular features. RESULTS: The two pathologists had concordance rates of 90.5% and 66.7% between their image and glass diagnoses. For each pathologist's discordant cases, 100.0% and 85.7%, respectively, were due chiefly to suspicious rather than definitive diagnoses. CONCLUSION: Evaluation of the electronic images indicated that almost all the cellular features were comparable to those viewed though a microscope.