Diagnostic Value of Fine-Needle Aspiration in Male Breast Lesions

Hoda, Raza S; Arpin, Ronald; Gottumukkala, Ravi V.; Hughes, Kevin S.; Ly, Amy; Brachtel, Elena F.

doi:10.1159/000494486

Cited by 12 publications

(9 citation statements)

References 38 publications

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“…The majority of cases in our study were benign neoplasms (57%), which is comparable to studies in the literature [10,11]. To establish the ROM for category 2 is difficult since most cases with benign diagnosis (mainly gynecomastia) (shown in Fig.…”

Section: Discussionsupporting

confidence: 85%

“…The rate of insufficient diagnoses at our institution was high (40%) compared to 5.77 and 6.8%, with most studies showing insufficiency rates in the single digits [9-11]. Our high inadequacy rate can be attributed to an increased number of FNAB performed at referral hospitals by personnel with limited experience in performing FNAB and poor-quality smearing technique.…”

Section: Discussionmentioning

confidence: 71%

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Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

et al. 2020

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Objective: This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. Study Design: Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. Results: The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. Conclusion: This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 71%

Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

et al. 2020

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“…It is responsible for <0.1% of men dying from any malignancy (24). In earlier studies on male breast pathologies, its malignant etiology was recorded in 2.5%-28.4% of the cases (1,4,7,18,20,25). Risk factors include older age, family history of breast cancer, radiation exposure, cryptorchidism, testicular trauma, Klinefelter syndrome, liver disease, and BRCA2 gene mutation.…”

Section: Discussionmentioning

confidence: 99%

Cytological Evaluation of Pathological Male Breast Lesions

Mondal¹,

Mandal²

2021

EJBH

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Morphologically, the male breasts, like its female counter organs, consist of glandular and adipose tissues. However, in men, glandular units are composed of ducts only, which are typically circumscribed underneath the nipple-areolar complex (1). Pathological lesions in male breasts are not common. Gynecomastia is the most common lesion in men. Its prevalence varies from 32% to 65% with respect to age groups. In postmortem male breast specimens, gynecomastia has been reported in 45%-50% of the cases (2). Similarly, carcinomas rarely occur in male breasts. It accounts for 1% of all breast cancer cases arising in both sexes, and approximately 1% of all malignancies occur in men. Clinically, it resembles gynecomastia as well as any other benign pathological lesions associated with male breast enlargement. Therefore, urgent discrimination of these two contrasting pathological entities is necessary (3). For this purpose, core needle biopsy and the recently amended vacuum-assisted breast biopsy are the most useful diagnostic method. However, as the most common male breast pathology, gynecomastia is best cured conservatively; it is therefore unreasonable to consider biopsy as the primary diagnostic intervention. On the contrary, fine needle aspiration cytology (FNAC) provides prompt and precise diagnoses economically and conveniently (4, 5). This study aimed to cytologically evaluate various pathological lesions that affect the male breasts and to validate the diagnostic accuracy of FNAC against the histopathology wherever practicable.

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Section: Discussionmentioning

confidence: 99%

“…It constitutes approximately 5% of all breast cancers in men, compared with 1%-2% in women with breast carcinomas (24). Non-Hodgkin lymphoma, malignant melanoma, oncocytic carcinoma, secretory carcinoma, mucinous carcinoma, and metaplastic carcinoma have been rarely reported (1,18,20,(24)(25)(26)(27)(28). Metastatic involvement of male breasts with SCC and melanoma are also identified sporadically (26).…”

Section: Discussionmentioning

confidence: 99%