Radiation change
Radiation change FNA cytology of irradiated breast tissue can be a diagnostic challenge. Histological changes include epithelial atypia in the terminal duct-lobular units and in larger ducts. Therefore, having knowledge of prior irradiation therapy is crucial to avoid a false-positive diagnosis of malignancy. FNA smears show atypical cells with nuclear and cytoplasmic enlargement and degenerative […]
Benign lesions
Benign lesions Breast cysts Mastitis Subareolar abscess Fat necrosis Fibrocystic change Fibroadenoma Papilloma Pregnancy and lactational changes Gynecomastia Radiation change
Breast carcinoma
Breast carcinoma Invasive ductal carcinoma, Not Otherwise Specified (NOS) Invasive Lobular carcinoma Intraductal carcinoma (DCIS) Medullary carcinoma Mucinous (colloid) carcinoma Tubular carcinoma Adenoid cystic carcinoma Papillary carcinoma Other rare variants of breast carcinoma
Cysts
Cysts The most common lesions of the breast are solitary and multiple cysts. Aspiration of the cysts is an excellent procedure for both diagnosis and treatment. Following aspiration of the cyst, it is important to palpate the area again to determine whether a residual mass is present, and if so, additional aspirations of the residual […]
Ductal carcinoma, Not Otherwise Specified (NOS)
Invasive ductal carcinoma, Not Otherwise Specified (NOS) Invasive ductal carcinoma is the most common type of breast carcinoma, accounting for approximately 75% of all invasive carcinoma. FNA specimens of ductal carcinoma, Not Otherwise Specified (NOS) usually show cytological features common to all breast carcinomata. Cytological diagnostic features High cellularity Loosely cohesive groups and single atypical […]
Mastitis
Mastitis FNA cytology of acute mastitis shows yellowish or greenish fluid with numerous neutrophils and foamy macrophages, with abundant background debris. Epithelial atypia resulting from the acute inflammatory process can be seen. Atypical epithelial cells can show features of regeneration and repair, with groups of cells arranged in a flat, streaming pattern with maintainance of […]
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: […]
C1: Inadequate
The designation of an aspirate as inadequate is sometimes subjective. The experience of the aspirator and/or the interpreter plays a decisive role. Adequacy is based on the presence of sufficient numbers of epithelial cells to provide a reliable assessment. C1 ideal rates must be lower than 10%. In case the lab exceeds 20% FNAs tecnicque […]
C2: Benign
C2 (benign) This category indicates an adequate sample without evidence of significant atypia or malignancy. Benign cases consist of monolayers of uniform ductal cells with round-oval shaped nuclei whose size is similar to that of red blood cells. Dispersed individual and paired naked nuclei can be seeni in the background If a cyst has been […]