Pregnancy and lactational changes
Pregnancy and lactational changes Most breast lesions in pregnant and postpartum women are benign and result from hormonal stimulation of breast tissue. Pregnancy can produce lactating adenomata or cause enlargement of pre-existing breast lesions such as fibroadenomata. Lactating adenoma and lactational change – cytological diagnostic features Cellular smears Bubbly vacuolated secretion in the background Numerous […]
C5: Malignant
This category indicates an adequate sample showing cells characteristic of carcinoma, or other malignancy. Malignancy should never be diagnosed on the basis of a single criterion. Combinations of the features listed in the following table will be always necessary to achieve the diagnosis. Criterion Benign Malignant General characteristics Cellularity Usually poor or moderate Usually high […]
Gynaecomastia
Gynaecomastia Gynaecomastia is a hormonally dependent lesion appearing most often in adolescents and older male patients. It can be classified as juvenile, idiopathic or drug-related. Cytological diagnostic features Low to moderate cellularity Groups of ductal cells Occasional apocrine cells Occasional mild nuclear atypia and nucleoli Stromal bipolar naked nuclei
Medullary carcinoma
Medullary carcinoma Medullary carcinoma is a rare type of breast carcinoma, usually occurring in the fifth and sixth decade of life. It characteristically presents as a well-demarcated lesion. Medullary carcinoma has been thought to have a better prognosis than ductal carcinoma NOS, although some studies have suggested that this is not true. Cytological diagnostic features […]
Evaluation of the specimen
Evaluation of nipple secretions Evaluation of FNA specimens Evaluation of nipple secretions A nipple discharge may be unilateral or bilateral; unilateral ones are more likely to be malignant. The secretion can be milky, serous, purulent or bloody. Cancer is most prevalent when the discharge is macroscopically bloody. Benign nipple secretions – cytologic diagnostic features Usually […]
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 […]
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: […]
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 […]