Interpretation of fine needle aspiration cytology of the breast: a comparison of cytological, frozen section, and final histological diagnoses

Bofin, Anna M.; Lydersen, Stian; Isaksen, C. V.; Hagmar, Björn

doi:10.1111/j.1365-2303.2004.00159.x

Cited by 12 publications

(5 citation statements)

References 28 publications

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“…In addition, when the authors excluded the inconclusive cases, their level of agreement increased to 93.1 and 96.7%, respectively. The results were at variance with findings of Bofin et al [11], who reported 84.6% of correlation between cytological and histological diagnoses of mammary tumours.…”

Section: Discussioncontrasting

confidence: 53%

“…Histologically, 25–30% of epithelial malignancies are in the group of specialized breast carcinoma like lobular, papillary, apocrine, tubular, cribriform, medullary, mixed, etc. [10,11]. In order to deciding the best type of treatment, sub typing of breast tumors using aspiration cytology is useful.…”

Section: Discussionmentioning

confidence: 99%

“…When applied to mammary gland lesions, the method shows good diagnostic accuracy. Moreover, it is a simple, rapid and low cost method, with minimal risk for the patien [11,12]. In veterinary medicine, the use of cytology as a diagnostic method is very recent and has been growing in the last 20 years [13].…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED ARTICLE: Comparative value of clinical, cytological, and histopathological features in feline mammary gland tumors; an experimental model for the study of human breast cancer

et al. 2013

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BackgroundThe diagnosis of breast lesions is usually confirmed by fine-needle aspiration cytology (FNAC) or histological biopsy. Although there is increasing literature regarding the advantages and limitations of both modalities, there is no literature regarding the accuracy of these modalities for diagnosing breast lesions in high-risk patients, who usually have lesions detected by screening. Moreover, few studies have been published regarding the cytopathology of mammary tumors in cats despite widespread use of the animal model for breast cancer formation and inhibition. The objective of the present study was to evaluate the diagnostic interest of cytological and histopathological analysis in feline mammary tumours (FMTs), in order to evaluate its possible value as an animal model.MethodsThe study was performed in 3 female cats submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female cats were of different breeds (1 siamese and 2 persians). Before surgical excision of the tumour, FNA cytology was performed using a 0.4 mm diameter needle attached to a 8 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained.ResultsCytologically, atypical epithelial cells coupled to giant nucleus, chromatin anomalies, mitotic figures, spindle shape cells, anisocytosis with anisokaryosis and hyperchromasia were found. Histologically, these tumors are characterized by pleomorphic and polygonal cell population together with mitotic figures, necrotic foci and various numbers inflammatory foci. Also, spindle shaped cells, haemorrhage localized in the different regions, local invasiveness and enlarged nuclei were observed. The samples included 3 tumors of mammary glands mammary tumors were complex carcinomas (n = 2) and adenocarcinoma (n = 1). The histological grades of the 3 cases were as follows: grade II, (1/3); grade III, (2/3) with high mitotic index. The preferential localization of mammary neoplasms was in the inguinal lobe (1/3 case) and abdominal lobes (2/3 cases). Furthermore, 1case of the inguinal mass affected the left caudo-inguinal lobe and 2cases right cranio and caudo abdominal lobes.ConclusionThe study concluded that cytology could be used as a quick, rapid, field diagnostic technique in combination with histopathology for the diagnosis of feline mammary tumors (FMTs). Our findings in feline MTs indicate that FMTs could be useful as an animal model of human breast cancer. Moreover, because of the similarity of the cytohistopathological findings in the human and feline mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for th...

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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RETRACTED ARTICLE: Comparative value of clinical, cytological, and histopathological features in feline mammary gland tumors; an experimental model for the study of human breast cancer

et al. 2013

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“…In the practical setting, the C3 category is used when there is a level of diagnostic uncertainty. The number of C3 cases resulting in malignancy varies in the literature from 24.6 to 52% [19,20,21,22,23,24,25]. In this study, the overall rate of malignancy was 37.4%; however, the screening population yielded a much greater proportion of malignant outcomes at 50% when compared with the symptomatic population at 32%.…”

Section: Discussioncontrasting

confidence: 39%

The True Nature of Atypical Breast Cytology

Weigner

Zardawi²,

Braye³

2013

Acta Cytologica

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Background: Atypical breast cytology is a poorly understood heterogeneous category with limited clinical utility but significant implications for patient management. Objective: To provide an insight into the true nature of atypical breast cytology in screening-detected (asymptomatic) and symptomatic settings, and find strategies for reducing the use of this diagnostic category. Materials and Methods: A total of 6,415 breast cytology samples were processed between January 2004 and December 2008. An atypical cytological diagnosis was rendered in 256 (4%) of the cases. A blind microscopic review of the atypical cases was conducted and results were correlated with subsequent histological and/or clinical outcomes. Results: Follow-up information by histology was available in 85.5%, by repeat fine-needle aspiration (FNA) in 3.5% and by imaging or clinical follow-up in 10.2% of the cases. Two patients (0.8%) were lost to follow-up. Of the 254 cases with follow-up, 62.6% were benign and 37.4% were malignant. The benign to malignant ratios were 1:1 and 2:1 in the screening and symptomatic groups, respectively. The atypical category in the screening population mostly yielded fat necrosis, complex sclerosing lesions and low- to intermediate-grade carcinoma on follow-up. The main outcomes in the symptomatic group were papilloma, fibroadenoma, ductal carcinoma in situ and lobular carcinoma. Preanalytical (suboptimal samples) factors were encountered in 34.8% and interpretative factors in 65.2% of the cases. Uncertainty about cellular morphology was attributed to such a diagnosis in 38 (14.8%) of the cases, architectural complexity in 137 (53.5%) and morphology and architecture in 70 (27.3%); 4.3% of cases were considered nondiagnostic. Conclusion: The atypical category is a necessary diagnosis but of limited use from a patient management perspective. Some preanalytical factors such as poor sample quality can be minimized by the involvement of cytopathologists in the FNA procedure. The use of the atypical category is partly dependent on the experience and confidence of the reporting pathologist. Assigning a case to this category is also likely to be unduly influenced by clinical or radiological findings. Our study indicates that the use of the atypical category can be reduced by up to 40% by appreciating these contributing factors. The practical utilization of the atypical category in breast cytology remains subjective and further study is required to identify useful objective criteria.

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“…There are enough evidence-based criteria to reliably categorise these lesions. A suspicious (C4) result usually suggests a high probability of cancer but is not as definitive as C5 either because of scant diagnostic material or low grade morphology (3,13,14). A non-diagnostic (C1) report provides limited information and highlights either sampling or technical problems.…”

Section: Leading Articlementioning

confidence: 99%