Morphometric Analysis in Breast Lesions A Rapid Conjunct to Intraoperative Imprint Smears

Breast carcinoma is the most common malignant tumor and leading cause of cancer deaths in women. While fine needle aspiration cytology is highly accurate in the diagnosis of breast lesions, it possesses certain drawbacks. In those circumstances intraoperative imprint cytology assumes importance, however, imprint cytology is subjected to interpretative errors. Computer image analysis has become an important tool in the pathology laboratory for quantitative morphometric analysis. The purpose of this study was to compare the morphometric values of various breast lesions on intraoperative imprint smears with final histopathological sections. The study group comprised 30 cases of, borderline (suspicious), and malignant lesions. Intraoperative imprint smears were stained with hematoxylin and eosin, and toluidine blue. Morphometry was done on these smears and compared with morphometry on the histopathological sections, followed by statistical correlation. We studied the following five parameters: mean nuclear area, mean nuclear diameter, mean nuclear perimeter, feret circle, and nucleo-cytoplasmic ratio. In the current work, all of the studied parameters with the exception of feret circle showed significantly lower values in benign ductal epithelial cells compared to malignant lesions and concentrate on the importance of morphometry as a diagnostic tool that could differentiate benign from malignant lesions, especially if it can be employed on imprint smears intraoperatively. Accurate assessment of intraoperative margins by imprint smears using image analysis automation can prevent multiple re- excision procedures in breast conservation surgery.