An audit of cytology in the evaluation of nipple discharge. A retrospective study of 10 yearsʹ experience

A retrospective analysis of cytology records for 10 years — up to June 1992 — identified 338 assessments of smears from nipple discharges. Cytology reports were located for 329 of the cases, 244 (74%) of which came from breast clinics at two Newcastle teaching hospitals. One clinic (184 smears) assesses all discharges cytologically, the other (60 smears) only those with a history of blood staining. Case notes were obtained for 216 cases (88.5%) enabling the cytology report to be compared with the final clinical or histological diagnosis. Of the 216, 174 (80.6%) were negative with respect to carcinoma and papilloma. Cytology identified 7 confirmed carcinomas and 1 false positive; 8 additional carcinomas were not detected. One papilloma was correctly identified by cytology; there were 12 false positives and 13 false negatives. The overall incidence of carcinoma was 6.9% and of papilloma 6.5%. Regarding carcinoma, cytology had a sensitivity of 46.5% and specificity of 99.5%. For papilloma, the sensitivity was 7% and the specificity 93.5%.