Cytology as an Oral Lesion Surgical Biopsy Timing Instrument

Objective: For patients with certain risk factors and suspicious oral cavity lesions not meeting criteria for immediate surgical biopsy, we evaluated the use of a brush biopsy cytology as a screening tool to assist in choosing between treatment options of immediate surgical biopsy and patient observation. Method: Oral mucosal brush biopsy cytology was performed on patients with risk factors and mildly suspicious lesions in the oral cavity. Specimens obtained were reviewed for presence of abnormal or dysplastic cells. Data were collected from 2008 to 2011. We correlated the results with the follow-up treatment decisions. Results: During the study period, 52 patients had brush biopsies. Pathology results in 21% (P < 0.01) of cases showed presence of abnormal or dysplastic cells and an immediate follow-up surgical biopsy was performed. In 71% of cases, results did not reveal abnormal cells, and patients were put under observation. In 7% of cases results indicated a fungal infection, and patients were treated. Conclusion: Where brush biopsy cytology revealed presence of abnormal or dysplastic cells, an immediate follow-up scalpel biopsy was recommended. Brush biopsy cytology from suspicious lesions provides information to aid in determining the treatment pathway for suspicious oral mucosal lesions not meeting criteria for an immediate surgical biopsy.