Cytologic Findings with Histologic Correlation in 43 Cases of Mammary Intraductal Adenocarcinoma Diagnosed by Aspiration Biopsy

Cangiarella, Joan; Waisman, Jerry; Simsir, Aylin

doi:10.1159/000326669

Cited by 21 publications

(12 citation statements)

References 33 publications

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“…In surgical pathology, LGDCIS is often an incidental finding in association with both benign and malignant lesions, or a lesion that is found in the work up of mammographic calcifications [80]. FNAB cytology cannot specifically diagnose LGDCIS and at the same time exclude invasive carcinoma [79, 81, 82]. …”

Section: Category: Suspicious Of Malignancymentioning

confidence: 99%

The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

et al. 2019

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The International Academy of Cytology (IAC) gathered together a group of cytopathologists expert in breast cytology who, working with clinicians expert in breast diagnostics and management, have developed the IAC Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy (FNAB) Cytology. The project was initiated with the first cytopathology group meeting in Yokohama at the 2016 International Congress of Cytology. This IAC Yokohama System defines five categories for reporting breast cytology, each with a clear descriptive term for the category, a definition, a risk of malignancy (ROM) and a suggested management algorithm. The key diagnostic cytopathology features of each of the lesions within each category will be presented more fully in a subsequent atlas. The System emphasizes that the crucial requirements for diagnostic breast FNAB cytology are a high standard for the performance of the FNAB and for the making of direct smears, and well-trained experienced cytopathologists to interpret the material. The performance indicators of breast FNAB, including specificity and sensitivity, negative predictive value, positive predictive value and ROM stated in this article have been derived from the recent literature. The current practice of breast FNAB has evolved with the increasing use of ultrasound guidance and rapid on-site evaluation. Two recent publications have shown a range of ROM for the insufficient/inadequate category of 2.6–4.8%, benign 1.4–2.3%, atypical 13–15.7%, suspicious of malignancy 84.6–97.1%, and malignant 99.0–100%. The management algorithm in the System provides options because there are variations in the management of breast lesions using FNAB and core-needle biopsy in those countries utilizing the “triple test” of clinical, imaging, and FNAB assessment, and also variations in the availability of CNB and imaging in low- and middle-income countries. The System will stimulate further discussion and research, particularly in the cytological diagnostic features of specific lesions within each category and in management recommendations. This will lead to continuing improvements in the care of patients with breast lesions and possible modifications to the IAC Yokohama System.

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Section: Category: Suspicious Of Malignancymentioning

confidence: 99%

The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

et al. 2019

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“…Cell clusters are usually 3-dimensional with a papillary, solid or cribriform (regular round/oval spaces with surrounding, uniform, rounded cells) pattern. Individual cells are polygonal or cuboidal with round-to-oval nuclei and occasional small nucleoli [71,72,73,74,75,76,77,78,79]. ME cells within epithelial clusters and in the background are usually absent.…”

Section: Proliferative Breast Lesionsmentioning

confidence: 99%

“…The absence of ME cells helps distinguish it from benign proliferations. A distinction between invasive low-nuclear-grade carcinomas and in situ lesions is not possible [71,72,73,74,75,76,77,78,79]. …”

Section: Mammary Carcinoma and Its Variantsmentioning

confidence: 99%

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

2013

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Objective: To review our experience and the literature on inconclusive/erroneous fine-needle aspirates (FNAs) of breast with the focus on the ‘true gray zone'. To describe the cytology, differential diagnosis, pitfalls and limitations of common and rare lesions. Study Design: We conducted a literature search focusing on breast FNAs with statistical data of C3 and C4 categories including false-positive and false-negative cases. Similar data from 2003 to 2009 was obtained from our institution. Results: C3 and C4 categories account for 3-17% of breast FNAs. Contributing factors are technical difficulties, inexperienced pathologists interpreting FNAs of breast and overlap of cytologic features of certain benign and malignant conditions; this last, ‘true gray zone' accounts for 2% of cases. Fibroadenoma, proliferative breast lesions, gynecomastia, infiltrating and in situ low-grade adenocarcinomas and tubular, cribriform, lobular and mucinous carcinomas are the most common problematic lesions. Granular cell tumor, adenomyoepithelioma, pregnancy-related lesions, fat necrosis, inflammatory and radiation changes, adenoid cystic carcinoma, spindle-cell lesions and Phyllodes tumor are less common. Conclusion: Inconclusive/erroneous FNAs of breast due to the ‘true gray zone' are rare. Most are due to the overlapping cytologic features of some benign and malignant conditions. Practical features that may help arrive at the correct diagnoses are elucidated.

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“…Besides the distinction of benign from malignant breast lesions, cytology is often able to provide information about specific tumor types of breast neoplasms and to distinguish non-proliferative from epithelial proliferative lesions. [1][2][3][4][5][6][7][8] Since therapeutic planning is frequently made preoperatively on the basis of the cytologic report, it is important to gather as much prognostic information from the cytologic specimen as possible. Histologic tumor type, tumor grade, steroid receptor status and cellular proliferative rate are important prognostic indicators that can be evaluated at the cytologic level.…”

Section: Tumor Typing Was Accurate In 73 Ofmentioning

confidence: 99%

Cytologic Evaluation of Prognostic Markers in Breast Carcinoma

Jayaram

Elsayed²

2005

Acta Cytologica

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Cytologic Findings with Histologic Correlation in 43 Cases of Mammary Intraductal Adenocarcinoma Diagnosed by Aspiration Biopsy

Cited by 21 publications

References 33 publications

The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

Cytologic Evaluation of Prognostic Markers in Breast Carcinoma

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