Cytology Nipple Secretions

Submit specimen with a Pathology requisition.
Label specimen container with patient's complete first and last name, date of birth, date and time of collection, and specimen source.

AP009

•Send the specimen to the Laboratory in an appropriate closed, labeled container with the appropriate fixative for the tests requested. If you are unsure of the proper fixative, contact the Histology laboratory at extension 3405 for clarification. • Specimen source If submitting multiple specimens, the label must match the requisition as A, B, C, D, etc. Label specimen container with patient's complete first and last name, date of birth, date and time of collection, and specimen source. Optimally, the specimens should be submitted to the laboratory unfixed or placed in Cytolyt fixative. After collection, the unfixed material must be sent to the laboratory as soon as possible. Cellular autolysis begins immediately after the sample is collected (e.g., urine or bloody serous effusion). Collection of each type of specimen is presented here for correct procedure. Diagnostic cytology is based on three basic sampling techniques: (1) collection of exfoliated cells, (2) collection of cells removed by brushing or similar abrasive techniques, and (3) aspiration biopsy or removal of cells from non-surface bearing tissues by means of a needle, with or without a syringe. If there is an unavoidable delay encountered in the delivery of the specimens (e.g., weekend, etc.), specimens must be refrigerated or preserved with Cytolyt fixative. Specimens can be refrigerated for a week or more and still be satisfactory. DO NOT freeze the specimens. Freezing will fracture cells.

1. Label several clean glass slides with patient's name, date, and type of specimen. 2. Open a bottle with fixative (95% ethyl alcohol) and ask patient to hold the open bottle below the breast. 3. Gently express only the nipple and subareolar area using the thumb and forefinger. If no secretion appears at the nipple after gentle compression, do not manipulate further. 4. If secretion occurs, allow only a drop the size of a pea to accumulate upon the apex of the nipple. If a big drop is obtained, it could be smeared on the slide using a hemacytometer cover glass. 5. Immobilize the breast with one hand. 6. With the other hand, place slide upon the nipple, momentarily pause to allow the material to spread a bit laterally, then draw the slide quickly across the nipple. 7. Immediately drop slide into fixative. 8. Repeat procedure and make as many smears as material permits. 9. Send specimen and completed requisition form to the Cytopathology Laboratory. NOTE: While the secretion will adhere to a plain slide, all frosted slides are recommended for even greater cell recovery. Some smears can be stained with DIFF-QUIK. Obtain sample in similar fashion, using plain glass slides, and allow smears to air-dry or spray fix.