Subareaolar abscess
Subareaolar abscess Subareolar abscess is an inflammatory lesion involving the lactiferous ducts in the subareolar region. Squamous metaplasia of the lactiferous duct results in obstruction and subsequent rupture of the duct, with release of keratinous debris into the surrounding stroma. This induces a foreign body reaction, with acute and chronic inflammation. Cytological diagnostic features Squamous […]
Intraductal carcinoma (DCIS)
Intraductal carcinoma (DCIS) Cytological features of intraductal carcinoma (ductal carcinoma in situ, DCIS) vary according to whether a comedo or non-comedo type of DCIS is aspirated, the latter being characterized by intraductal necrosis. DCIS, comedo type – cytological diagnostic features Moderate to high cellularity Loosely cohesive groups and single cells Large pleomorphic cells Abundant necrotic […]
Fat necrosis
Fat necrosis Fat necrosis is a benign breast lesion which can radiologically, clinically and histologically (especially on frozen sections) simulate malignancy. Only a minority of patients report a history of trauma. FNA specimens show necrotic and degenerating adipocytes with amorphous debris, inflammatory cells (neutrophils, plasma cells, lymphocytes) and numerous lipid-laden macrophages (lipophages). Multinucleated foreign body-type […]
Mucinous (colloid) carcinoma
Mucinous (colloid) carcinoma Mucinous (colloid) carcinoma accounts for approximately 5% of breast carcinomas and typically occurs in older women. It is associated with a better prognosis than the invasive ductal carcinoma NOS. Mucinous carcinomas can be divided into pure, mixed and signet ring cell carcinoma, with the latter having the worst prognosis. Mammography usually shows […]
Fibrocystic change
Fibrocystic change Fibrocystic change is the most common lesion to produce a breast mass in women aged over 30. Up to 50% of women have palpable ‘lumpiness’ and up to 90% show histological changes. The lesions of fibrocystic change, usually multiple and bilateral, are the most common palpable lesions sampled by FNA. Histologic features include […]
Fibroadenoma
Fibroadenoma Fibroadenoma is the most common breast neoplasm, occurring in all age groups, but especially common in young women from 20 to 35 years of age. In contrast with the ill-defined nature of fibrocystic change, fibroadenomata are movable, discrete nodules, measuring usually less than 4 cm in maximum dimension. They often increase in size with […]
Fine needle aspiration (FNA)
Fine needle aspiration (FNA) FNA is widely used to evaluate palpable lesions or those detected by radiology (e.i. ultrasound and/or mammography). FNA and core biopsies provide early detection of malignancies without performing open surgical biopsies. FNA is performed using a 23-25 gauge needle with a 10 mL syringe. A local anaesthetic is usually not used because […]
Anatomy and histology of the breast
The breast contains 15-25 lactiferous ducts, which begin at the nipple, branch into smaller ducts and end in the terminal duct lobular unit (lobule), which is composed of a terminal duct and many small ductules (or acini). The ducts and ductules are lined by an inner layer of cuboidal to columnar epithelial cells and an […]
Nipple discharge cytology
Nipple discharge cytology A spontaneous nipple discharge not related to lactation or pregnancy is an abnormal finding. It may result from a lesion in the breast (such as papilloma or carcinoma) or from a hormonal abnormality (such as a prolactin-secreting pituitary adenoma). Cytologic examination of a nipple discharge is usually helpful when no palpable or […]
Reporting terminology
There is no definitive definition in reporting system in Europe. To maximize the mutual understanding and to improve the diagnostic standardization all breast FNAs cytology specimens should be coded using one of the following five reporting categories as defined by the U.K. Breast Screening Programme in 1993 in the U.K. These categories are: C1: Inadequate C2: […]