Role of cytotechnologists in rapid onsite adequacy assessment of cytology materials for diagnostic workup and specimen allocation for ancillary testing using a standardized protocol.

INTRODUCTION: Data on the performance of cytotechnologists in assessing specimen adequacy of needle core biopsies (NCB) is scant and their role in specimen triaging for ancillary studies have not been well established. MATERIALS AND METHODS: We retrospectively analyzed rapid onsite evaluation (ROSE) performed exclusively by cytotechnologists on 248 NCB and fine-needle aspiration (FNA) specimens. Overall adequacy and accuracy rates were determined by comparing to final diagnosis. We also reviewed the process of specimen allocation for ancillary testing to determine whether specimens were appropriately triaged at the time of ROSE. RESULTS: Of the 248 cases, 222 (89.5%) were touch imprint and 26 (10.5%) were FNA smears. The overall adequacy rate was 73.4% (182 of 248). Concordance for "adequate" interpretation by ROSE with unequivocal malignant or benign diagnoses on final interpretation was 95.6%. The sensitivity, specificity, and accuracy of ROSE for a final "positive for malignancy" were 89.2% (95% CI 83.04% to 93.69%), 43.24% (95% CI 31.77% to 55.28%), and 73.87% (95% CI 67.57% to 55.28%), respectively. Cases with "positive for malignancy" on final diagnosis were "adequate" by ROSE in 89.1% (132 of 148) and "inadequate" in 10.8% (16 of 148), P < 0.0001. Ancillary tests were performed in 168 of 248 (67.7%); the majority were immunohistochemical stains for determining tumor subtype. Predictive biomarkers were performed successfully in 100% of metastatic breast cancers. CONCLUSIONS: Cytotechnologists performed at a high level of competency in providing ROSE and allocating specimens for ancillary testing, which were performed successfully in the majority of cases. Implementation of a standardized protocol for tissue management/prioritization is of paramount importance to maximize tissue preservation and minimize wastage.

Educação em saúde no serviço de radiologia: orientações para punção aspirativa de mama e tireóide / Educación en Salud en el Servicio de Radiología: orientaciones para punción de mama y tiroides / Health education in radiology service: orientations for breast and thyroid aspiration puncture

Trata-se de pesquisa convergente assistencial desenvolvida no Serviço de Radiologia de hospital-escola, cujo objetivo é conhecer as expectativas e dúvidas dos clientes submetidos à Punção Aspirativa por Agulha Fina de mama e tireoide. A coleta de dados ocorreu de setembro de 2010 a abril de 2011, por meio de 10 encontros educativos em sala de espera e entrevistas com 88 clientes. Os resultados apresentam: percepção dos clientes em face do exame, o câncer como estigma e a educação em saúde como estratégia de enfrentamento. Revelaram também presença de sentimento de medo do procedimento e do diagnóstico de câncer. A prática educativa em sala de espera é um espaço que minimiza a ansiedade e permite a troca de experiências e conhecimentos entre profissional e cliente, bem como favorece uma rede de apoio entre os clientes. Caracteriza-se como espaço importante de atuação do enfermeiro no Serviço de Radiologia.

Una investigación convergente asistencial desarrollada en el Servicio de Radiología del hospital docente, cuyo objetivo es conocer las dudas y expectativas de los clientes sometidos a la Punción Aspirativa por Aguja Fina de mama y tiroides. La recolección de datos se realizó desde setiembre de 2010 hasta abril de 2011, por medio de 10 encuentros educativos con formato de sala de espera y entrevistas con 88 clientes. Los resultados revelaron: la percepción de clientes antes del examen, cáncer como estigma y educación para la salud como una estrategia para confrontación. Además, se revelaron el miedo tanto al procedimiento como al diagnóstico. La práctica educativa en la sala de espera es un espacio privilegiado para disminuir la ansiedad y permite una red de apoyo entre los clientes y un campo importante para la enfermera en el servicio de radiología.

This is a convergent care research developed in a school hospital's radiology service whose purpose is to learn about the concerns and expectations of clients submitted to breast and thyroid Fine Needle Aspiration Puncture. Data collection was conducted from September 2010 to April 2011, through 10 educational meetings in the waiting room interviewing 88 clients. The results show: clients' perception of the test, cancer as a stigma and healthcare education as a confrontation strategy. In addition, they revealed fear of both the procedure and the diagnosis of cancer. Educational practice in the waiting room is a space to decrease anxiety and allows the exchange of experiences and knowledge between professional and client, it also fosters a support network among clients. It is characterized as important space of action to the nurse within radiology service.