Cytologic features of 22 radial scar/complex sclerosing lesions of the breast, three of which associated with carcinoma: Clinical, mammographic, and histologic correlation

Bonzanini, Mariella; Gilioli, Eliana; Brancato, Beniamino; Pellegrini, Marco; Mauri, M.; Palma, Paolo Dalla

doi:10.1002/(sici)1097-0339(199711)17:5<353::aid-dc8>3.0.co;2-b

Cited by 29 publications

(21 citation statements)

References 15 publications

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“…28,29 RSs present mammographically as stellate lesions, not infrequently mistaken for invasive carcinoma. 28,29 RSs present mammographically as stellate lesions, not infrequently mistaken for invasive carcinoma.…”

Section: Fibroadenomamentioning

confidence: 99%

Fine Needle Biopsy Cytology of Breast Lesions

Orell¹,

Miliauskas²

2005

Advances in Anatomic Pathology

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Screening mammography and greater community awareness of breast carcinoma have led to an increase in fine needle biopsies of the breast. As a consequence, a wide variety of cytologic patterns have been encountered and studied in benign, proliferative, and malignant breast lesions. We review the main reasons for diagnostic difficulties in breast cytology, the situations in which either a false positive or a false negative diagnosis is possible, as well as conditions whose incorrect typing can lead to inappropriate management.

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Section: Fibroadenomamentioning

confidence: 99%

Fine Needle Biopsy Cytology of Breast Lesions

Orell¹,

Miliauskas²

2005

Advances in Anatomic Pathology

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“…al. (24). The review of the specific cases containing tubules, showed round rather than sharp ends and obvious myoepithelial cells.…”

Section: Resultsmentioning

confidence: 97%

Stratification of risk of malignancy in atypical breast fine needle aspiration: a cytomorphological approach

Weigner

Zardawi²,

Braye

et al. 2017

J Diagnostic Path

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SummaryAlthough atypical (C3) breast cytology is a legitimate reporting category, it is not very useful clinically because it yields benign as well as malignant histological outcomes. Therefore, a cytomorphological approach to minimise inappropriate use of the C3 category may improve the clinical usefulness of this category. In a previous training set of 180 atypical breast cytology (C3) cases we had identified the best discriminating cytological criteria to predict the histological outcomes (malignant, benign proliferative and benign non-proliferative). Using a selection of these previously identified statistically significant criteria (cystic background, cohesiveness, myoepithelial cells or bare bipolar nuclei, papillary fragments and tubules) we tested their ability to predict the same outcomes on 182 subsequent C3 cases (validation set). The diagnostic accuracy for each outcome was compared with the training set. A probability calculator with nominated cut-points was developed to stratify and re-grade C3 cases. Cases outside the cut-points were either up-graded to suspicious (C4) or down-graded to benign (C2). Re-graded cases were reviewed to identify reasons for over or under-interpretation. Statistical analysis showed comparable diagnostic accuracy between the training set and the validation set for malignant and benign proliferative outcomes but not for the benign non-proliferative outcome. The probability calculator resulted in an up-grade of 18% (33/182) ofthe cases. Malignant histology was seen in 25/33 (76%) of the up-graded cases but 8/33 (24%) produced a proliferative non-malignant outcome. A meaningful lower cut-point could not be established without including malignant cases. The C3 category remains a legitimate with a heterogeneous mix of pathological entities. Attempts to minimise inappropriate allocation of C3 cases into this category have met with limited success.

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“…Consequently, mammographical follow-up itself is enough according to several authors [39]. Although RS does not have any specific cytological feature [36,25], its sensitivity (67%) and specificity (91%) of cytology makes this method suitable for differentiating between benign and malignant forms [25,[36][37][38]. Our and others experience proves that this process can be safely used for preoperative diagnosis [3].…”

Section: Cytologymentioning

confidence: 99%

Radial Scar-Significant Diagnostic Challenge

Egyed¹,

Péntek²,

Járay

et al. 2008

Pathol. Oncol. Res.

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The prevalence of radial scar (RS) is 0.04% in asymptomatic women participating in population screening for breast cancer. It is important to differentiate RS from concomitant malignancies, which occur in 20-30% of patients, or from small stellate carcinomas which give similar radiomorphology. The aim of our study was to evaluate the effectivity of current breast diagnostic methods in distinguishing between real RS, concomitant malignancy and carcinomas imitating RS. Diagnosis of RS was set up in 61 cases by mammography. Forty-four patients underwent surgical excision: histology showed benign or malignant lesions in 28 and 16 cases, respectively. A series of negative results at follow-up proved the benign nature of the lesion in further 11 cases. Six patients were not available for follow-up. Results of mammography, physical examination, ultrasonography and cytology were evaluated and were compared in 39 benign and 16 malignant cases. Results of examinations were reported on the BI-RADS scale ranging from 1 to 5. The mean categorical scores of all diagnostic processes were around the level of borderline lesions: mammography: 3.49, ultrasonography: 3.06, cytology: 2.47 and physical examination: 1.67. The average age of the patients in the benign and malignant groups were the same: 58 years. The two groups did not differ significantly over either distribution of coded mammographical results (p = 0.2092), or the distribution of mammographical parenchyma density patterns (p = 0.4875). However, the malignant and benign groups differed significantly from each other over the distribution of coded ultrasonographic (p = 0.0176) and cytological (p < 0.0001) results. In conclusion, in the preoperative diagnosis of asymptomatic "black-stars", mammography detects the non-palpable lesions, and ultrasonography together with cytology proved better in the analysis, provided FNAB is US guided. Due to the complex diagnostic approach the nature of the "black stars" is known in the majority of cases prior to the surgical biopsy.

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Cytologic features of 22 radial scar/complex sclerosing lesions of the breast, three of which associated with carcinoma: Clinical, mammographic, and histologic correlation

Cited by 29 publications

References 15 publications

Fine Needle Biopsy Cytology of Breast Lesions

Fine Needle Biopsy Cytology of Breast Lesions

Stratification of risk of malignancy in atypical breast fine needle aspiration: a cytomorphological approach

Radial Scar-Significant Diagnostic Challenge

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