Evidence map›Paper›PMID 34839426›Full record

SynthesisAnnals of surgical oncology2022

Diagnostic Accuracy of Nipple Discharge Fluid Cytology: A Meta-Analysis and Systematic Review of the Literature.

Natasha Jiwa, Swathica Kumar, Rishikesh Gandhewar, Hemali Chauhan, Vikneswaran Nagarajan, Corrina Wright, Dimitri Hadjiminas, Zoltan Takats, Hutan Ashrafian, Daniel Richard Leff

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Natasha JiwaDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK. natasha.jiwa04@imperial.ac.uk.
Swathica KumarRoyal College of Surgeons Ireland, Dublin, Ireland.
Rishikesh GandhewarDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
Hemali ChauhanDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
Vikneswaran NagarajanRoyal College of Surgeons Ireland, Dublin, Ireland.
Corrina WrightNorthwest London Pathology, Imperial College Healthcare Trust, London, UK.
Dimitri HadjiminasDepartment of Breast Surgery, Imperial College Healthcare Trust, London, UK.
Zoltan TakatsDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
Hutan AshrafianDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
Daniel Richard LeffDepartment of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK.
Imperial College London · GBSt Mary's Hospital · GBImperial College Healthcare NHS Trust · GBRoyal College of Surgeons in Ireland · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNipple discharge is the third most frequent complaint of women attending rapid diagnostic breast clinics. Nipple smear cytology remains the single most used diagnostic method for investigating fluid content. This study aimed to conduct a systematic review and meta-analysis of the diagnostic accuracy of nipple discharge fluid assessment.

methodsThe study incorporated searches for studies interrogating the diagnostic data of nipple discharge fluid cytology compared with the histopathology gold standard. Data from studies published from 1956 to 2019 were analyzed. The analysis included 8648 cytology samples of women with a presenting complaint of nipple discharge. Both hierarchical and bivariate models for diagnostic meta-analysis were used to attain overall pooled sensitivity and specificity.

resultsOf 837 studies retrieved, 45 fulfilled the criteria for inclusion. The diagnostic accuracy of the meta-analysis examining nipple discharge fluid had a sensitivity of 75 % (95 % confidence interval [CI], 0.74-0.77) and a specificity of 87 % (95 % CI, 0.86-0.87) for benign breast disease. For breast cancer, it had a sensitivity of 62 % (95 % CI, 0.53-0.71) and a specificity 71 % (95 % CI, 0.57-0.81). Furthermore, patients presenting with blood-stained discharge yielded an overall malignancy rate of 58 % (95 % CI, 0.54-0.60) with a positive predictive value (PPV) of 27 % (95 % CI, 0.17-0.36).

conclusionsPooled data from studies encompassing nipple discharge fluid assessment suggest that nipple smear cytology is of limited diagnostic accuracy. The authors recommend that a tailored approach to diagnosis be required given the variable sensitivities of currently available tests.

Indexed as

Breast NeoplasmsNipple DischargeCytodiagnosisFemaleHumansNipplesSensitivity and Specificity

Identifiers

PMID34839426
PMCPMC8627297
OpenAlexW3215375178

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.