Cytology of abnormal nipple discharge: a cyto‐histological correlation

Abstract

Spontaneous or expressible nipple discharge may occur in palpable and nonpalpable breast lesions. The aim of the study was to evaluate the sensitivity and specificity of nipple discharge cytology in palpable and nonpalpable breast lesions. One hundred and seventy-four nipple discharge specimens were reviewed, of which 82 had corresponding surgical pathology, including 34 palpable breast lesions and 48 nonpalpable breast lesions. There was good correlation between nipple discharge cytology and concomitant fine needle aspiration (FNA) cytology. Nipple discharge cytology is as specific as concomitant FNA cytology but is slightly less sensitive in detecting papillomas or malignant lesions. The sensitivity and specificity of the nonpalpable and palpable breast lesions were similar. Nipple discharge cytology is very helpful in detecting an underlying breast lesion even if the case has no palpable mass in the breast.

Breast duct microendoscopy in nipple discharge: microbrush improves cytology

“…These tests are minimally invasive and well tolerated [1]. Although nipple discharge cytology is as specific as guided fine-needle aspiration, it is less sensitive because the sample is not taken from a specific lesion [8].…”

Male Breast Cancer Presenting as Nipple Discharge

“…Current data suggest that ND cytological examination is only useful when positive and can have a false-negative rate for cancer of up to 50% [16, 17]. In our two patients, both underwent ND cytology, with cytology detecting suspicious malignant epithelial cells in one of the two patients.…”

Suspicious Nipple Discharge Diagnostic Evaluation

“…For example, Pritt et al (2004) determined a sensitivity and specificity of 85% and 97%, respectively. Likewise, a sensitivity of 58.3% and 63% and a specificity of 100% and 100% were reported by Lee (2003) and El-Daly & Gudi (2010), respectively. Therefore, ND cytology can be useful in the diagnosis of malignant and suspicious cases.…”

“…Gupta et al (2004) showed that 492 of 1948 ND smears (25%) were inadequate for diagnosis. Lee (2003) reported that ND cytology was non-diagnostic in 43 of 82 cases (52%), whereas FNA cytology was non-diagnostic in only 1 of 34 cases (2.9%). Therefore, ND cytology has little complementary diagnostic value.…”

“…It has been reported that ND cytology is as specific as concomitant FNA cytology but slightly less sensitive for detecting papillomas or malignant lesions (Lee, 2003). However, ND samples are often inadequate.…”