Significance of Squamous Cells in Fine Needle Aspiration Cytology of the Breast

Ng, Wai-Kuen; Kong, James

doi:10.1159/000326471

Cited by 24 publications

(13 citation statements)

References 18 publications

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“…Cytological studies of coelomic fluid and urine specimens have revealed that the cannibalism of tumour cells suggests a highly aggressive nature . A previous cytological report also described cannibalism findings in SCC of the breast . Cannibalism was not detected in any of the apocrine carcinoma cases examined in this study.…”

Section: Discussionsupporting

confidence: 50%

“…The number of subjects examined in this study is too small (n=10) to conclusively support the cytopathological characteristics of the poorly differentiated SCC of the breast; however, the current study examined more cases than similar reports. The cytopathology of breast SCC has been reported in three case reports (one each case) and two case studies (n=3 and 4) . These case reports included well differentiated SCC cases.…”

Section: Limitation Of This Studymentioning

confidence: 99%

“…A small number of reports have characterised the cytological features of mammary SCC, but these reports only documented cases of well‐differentiated SCC. These reports described SCC as exhibiting a streaming arrangement, nucleolar enlargement, dense nuclei, cannibalism, atypical keratinocytes and a necrotic background . To our knowledge, no studies have examined the cytological characteristics of poorly differentiated SCC of the breast …”

Section: Introductionmentioning

confidence: 99%

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Cytological diagnostic clues in poorly differentiated squamous cell carcinomas of the breast: Streaming arrangement, necrotic background, nucleolar enlargement and cannibalism of cancer cells

et al. 2017

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Objective: Squamous cell carcinoma (SCC) is a rare histological type of breast cancer. The cytological diagnosis of non-keratinising, poorly differentiated SCC is often difficult, and distinguishing it from invasive ductal carcinoma or apocrine carcinoma (AC) is especially challenging. We aimed to define the diagnostic cytological features of poorly differentiated SCC of the breast. Methods:We studied the cytological findings of poorly differentiated SCC (n=10) and compared them to those of IDC (n=15) and AC (n=14). The following six cytological features were evaluated: streaming arrangement, nucleolar enlargement, dense nuclei, cannibalism, atypical keratinocytes and necrotic background.Results: SCC exhibited significantly higher frequencies of streaming arrangement (70% vs 6.7%, P=.002), nucleolar enlargement (80% vs 27%, P=.02), and necrotic background (80% vs 36%, P=.002) than invasive ductal carcinoma. The detection of two or three of these features yielded a higher sensitivity (80%) and specificity (93%) for the diagnosis of SCC. Streaming arrangement (70% vs 0%, P<.001), cannibalism (60% vs 0%, P=.002), and a necrotic background (80% vs 36%, P=.047) were all significantly more frequent in SCC than in AC. When distinguishing SCC from AC, the presence of two or three of these features yielded a high sensitivity (80%) and specificity (100%).Conclusions: Cytological features such as a streaming arrangement, a necrotic background, nucleolar enlargement and cannibalism are useful indicators for the diagnosis of SCC of the breast. As such, greater attention should be paid to these morphological features in daily clinical practice. The cytological characteristics of apocrine breast carcinoma have been described as the presence of apocrine granules, an enlarged nucleolus and a low nucleus/cytoplasm ratio. The aim of this study was to clarify the cytological characteristics of poorly differentiated SCC of the breast to improve the quality of cytodiagnosis in comparing these characteristics with those of invasive ductal carcinoma and apocrine carcinoma of the breast.2 | ME TH ODS | Immunohistochemical proceduresFormalin-fixed and paraffin-embedded sections were examined immunohistochemically. After antigen retrieval (heat-treatment for 40 minutes at pH 9), the sections were incubated with anti-oestrogen-receptor antibodies (SPI, monoclonal; Nichirei Biosciences Inc., Tokyo, Japan) and anti-PgR antibodies (A9621A, monoclonal; Nichirei). After the endogenous peroxidase was quenched with 3% H 2 O 2 in distilled water, the slides were incubated with secondary antibody for 30 minutes. Then, the slides were subjected to peroxidase treatment using Histofine Simple Stain MAX-PO (MULTI; Nichirei) and a DAB substrate kit (Nichirei). Regarding HER2 (SV2-61c, monoclonal; Nichirei), immunohistochemical staining was performed according to the kit's protocol. The following were used as control groups: 15 cases with invasive ductal carcinoma, NOS and 14 cases with apocrine cancer. | Cytological evaluationFine needle aspiration ...

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Section: Discussionsupporting

confidence: 50%

Section: Limitation Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cytological diagnostic clues in poorly differentiated squamous cell carcinomas of the breast: Streaming arrangement, necrotic background, nucleolar enlargement and cannibalism of cancer cells

et al. 2017

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“…[78] The benign breast conditions with abundant squamous cells may sometimes mimic malignant squamous lesion and vice versa. In general, the presence of abundant foamy macrophages in the background suggests a benign lesion.…”

Section: Discussionmentioning

confidence: 99%

Primary intracystic squamous cell carcinoma of the breast: A case report and review of the literature

Teerthanath

Krishna

2009

J Cytol

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Primary intracystic squamous cell carcinoma (SCC) of the breast is an extremely rare entity and has a low incidence in comparison with other breast cancers. We report a rare case of primary intracystic SCC in a 45-year-old woman who presented with a cystic lump in the right breast. Cytological smears of the fluid aspirated from the breast tumor revealed malignant squamous cells dispersed in single and occasional groups along with numerous cyst macrophages, suggesting cystic SCC. Histological study of the mastectomy specimen confirmed the diagnosis of primary intracystic SCC. Although the presence of abundant foamy macrophages in the background of fine needle aspiration cytology smears of the breast suggest benign breast lesion, when associated with malignant squamous cells, these suggest cystic primary SCC or metastatic SCC. The primary SCC should not be confused with metaplastic change in other breast carcinomas.

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“…The abundance of background mucin, absence of dyskeratotic cells, low cytologic grade and rarity of mitotic figures also helps to distinguish this type of tumor from squamous cell (metaplastic) carcinoma of the breast. 19 The recognition of this peculiar morphologic feature in fine needle aspirates, besides avoiding misdiagnosis, may provide a clue to pure mucinous carcinoma, which carries a better prognosis as compared with mixed mucinous carcinoma.…”

Section: Discussionmentioning

confidence: 99%