Background: Fine needle aspiration cytology (FNAC) can have high inadequate results. The main objective of this study was to validate the sensitivity of imprint cytology and compare it to that of FNAC across all levels of staff experience. Our other objective was to find out whether handling of a core biopsy to obtain an imprint slide affected its morphology so as to make histopathological reporting from that tissue difficult. This we thought could be of significance while trying to diagnose smaller cancers where just one core could contain tumour. Methods: Patients (n = 56) with a suspicious breast lump had fine needle aspiration (FNA) and core biopsy. The core biopsy used to prepare the two imprint cytology slides was sent separately for histopathology reporting. Results: Simultaneous imprint cytology from a core biopsy increased the sensitivity of cytology results by 12% compared to that of FNAC alone. In this series we found imprint cytology to have a sensitivity of 84%, a specificity of 100%...

Imprint cytology from core biopsies increases the sensitivity of fine needle aspiration (FNA) in breast cancer patients.

Abwertung als Ziel

Im Januar erschien in der Online-Ausgabe der Tageszeitung „Die Welt“ ein Beitrag von Edzard Ernst mit dem Titel „Die Scheinwirkung der Osteopathie“ 1 . Seine Ausführungen zur Osteopathie führen zu einer Fundamentalkritik. Er rät von der osteopathischen Behandlung ab, ihre Nutzen-Risiko-Bilanz sei nicht positiv, so schreibt er, eine Empfehlung demnach unangebracht. Für Therapeuten, für Patienten, für osteopathisch Interessierte können sich seine Argumente durchaus schlüssig anhören. Zumal er von der „Welt“ „als einer der einflussreichsten Wissenschaftler auf dem Gebiet der Alternativmedizin“ vorgestellt wird. Das wiegt zusätzlich und macht Eindruck. Doch was bleibt von seinen Argumenten, wenn seine Ausführungen genauer untersucht und im Kontext der verfügbaren wissenschaftlichen Literatur zur Osteopathie betrachtet werden? Widmen wir uns für einen Moment dieser Frage.

<h2>Abstract</h2> Pseudoscience has harmful effects on individual patient care, professions and society more broadly. The propagation of pseudoscience and spread of misinformation by a healthcare discipline raises questions as to their legitimacy and ethical standing as a profession. Osteopaths and osteopathic physicians are regulated by law as healthcare professionals in many parts of the world with an expectation that relevant aspects of practice are suitably aligned with the scientific paradigm in the form of a commitment to the values of evidence-based practice. This article discusses the system of pseudoscience and considers its historic, present and potential negative impacts on osteopathy and professional progress. We identify possible incentives for some aspects of osteopathy and osteopaths to engage in pseudoscientific thinking and in doing so we discuss osteopathy's susceptibility to pseudoscience and how practitioners may become more aware of and recognise pseudoscientific information and pseudoexpertise. 

Pseudoscience - A skeleton in osteopathy's closet?

An exploration of the clinical reasoning used by registered osteopaths in their choice of therapeutic approach

INTRODUCTION: Core biopsy of the breast has become the method of choice for tissue diagnosis of screen detected microcalcifications and some mass lesions in many breast assessment centres. Biopsy results are not available until the following day. Imprint cytology of fresh breast core samples allows same-day reporting and patient counselling.



AIM: To determine the accuracy of core imprint cytology when compared with core biopsy diagnosis when used in a breast assessment centre setting.



METHODS: Core imprints (CI) were prepared and reported on all fresh core biopsies (CB) performed at the Sir Charles Gairdner Hospital Breast Centre from May to December 2000. Fresh core samples were placed on a glass microscope slide. Core radiographs were taken for microcalcification lesions (MC). A laboratory technician gently and quickly rolled the cores on the slide with fine forceps. The cores were fixed in formalin, processed and reported next day. The imprint slide was air dried and stained with DiffQuik. CI were reported using four categories: Insufficient, Benign, Indeterminate and Malignant. Counselling and planning for management were possible on the same day in women with malignant diagnoses. Clinicians were advised not to discuss negative or indeterminate CI results with women and to defer to the final CB report.



RESULTS: Cores were performed on 381 lesions. There were 83 carcinomas (38 in MC and 45 in masses) and 56 were called malignant on CI (absolute sensitivity 67.5%; 78.9% for MC and 57.8% for masses). 3 malignancies on CB were negative on CI giving a false negative rate of 3.6%. There were no false positive diagnoses. The predictive value of a benign diagnosis was 95.3%. There were no adverse effects in the histology of CB.



CONCLUSION: CI was an accurate method of providing an immediate diagnosis of malignancy in two thirds of malignancies confirmed on CB.

Core imprint cytology: a useful method for same‐day reporting

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An exploration of the clinical reasoning used by registered osteopaths in their choice of therapeutic approach

Core imprint cytology: a useful method for same‐day reporting