The cytopathology of ductal carcinoma <i>in situ</i> of the breast. A detailed analysis of fine needle aspiration cytology of 58 cases compared with 101 invasive ductal carcinomas

Bonzanini, Mariella; Gilioli, Eliana; Brancato, Beniamino; Cristofori, Alessandro; Bricolo, D.; Natale, N.; Valentini, A.; Palma, Paolo Dalla

doi:10.1046/j.1365-2303.2001.00308.x

Cited by 35 publications

(28 citation statements)

References 21 publications

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“…The recognition of these structures is important because they are often linked with invasive low-grade malignancy. Bonzanini et al [24],in their study of DCIS versus IDC, reported that tubular clusters were associated with IDC grade 1-2 in 89% of the cases. Guo et al [25 ]remarked on the exclusive association of tubular structures with invasive carcinoma, but that this finding was uncommon (11.5%).…”

Section: Discussionmentioning

confidence: 99%

The Microscopic Complexities of C3 in Breast Cytology

Weigner

Zardawi²,

Braye³

et al. 2014

Acta Cytologica

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Background: Fine-needle aspiration (FNA) of difficult breast lesions often results in an atypical (C3) report. The assortment of outcomes generated by C3 reports varies widely, and this has given rise to different clinical management pathways. Objective: To identify and objectively assess microscopic features associated with atypical/C3 breast FNA cases. Materials and Methods: A total of 230 atypical breast FNAs were subjected to a blind microscopic rescreen using a range of robust qualitative and quantitative cytological criteria including cellularity, architectural qualities, cytomorphology and background features. A logistic regression with a receiver operating characteristic (ROC) curve and the resultant forward stepwise analysis were conducted to assess the results. This statistical testing was measured against malignant, benign proliferative and benign non-proliferative outcomes. Results: The malignant and benign proliferative outcomes showed a mixture of opposing protective and predictive individual cytological criteria. The stepwise analysis produced models demonstrating the best combination of individual cytological criteria for malignancy, proliferative and benign non-proliferative entities. In the malignancy model, discohesion, nuclear crowding within sheets, diminished numbers of bare bipolar nuclei and myoepithelial cells, the presence of tubules or necrosis and the absence of a cystic background were important features. The benign proliferative model suggested the same criteria but with the opposite implication and with the addition of several others, such as the presence of apocrine metaplasia, retained polarity and a speckled or coarse chromatin pattern. Age was a significant factor in malignant and proliferative outcomes. The benign non-proliferative stepwise analysis produced a model with fewer criteria (complex sheets, bare bipolar nuclei and a cystic background) limiting clinical application. Conclusion: Atypical/C3 breast cytology remains a legitimate reporting category. However, it is associated with a number of different histological outcomes. The incidence of the C3 category can be significantly reduced by controlling extrinsic factors and understanding the associated microscopic features.

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Section: Discussionmentioning

confidence: 99%

The Microscopic Complexities of C3 in Breast Cytology

Weigner

Zardawi²,

Braye³

et al. 2014

Acta Cytologica

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“…20 A radiologic tumor or density will almost always represent an invasive carcinoma. 21,22 If identified radiologically, it will be sampled directly. A DCIS component within an invasive carcinoma might reveal the typical features of cytologic DCIS on the aspirated smears.…”

Section: Discussionmentioning

confidence: 99%

“…Bondeson et al 15 and Klijanienko et al 16 did not comment on this at all. In studies by McKee et al 1 and Bonzanini et al, 21 2 people had evaluated the criteria, but no interobserver variation was given. The reproducibility of the invasion criteria is unresolved.…”

Section: Discussionmentioning

confidence: 99%

Assessing Invasion Criteria in Fine Needle Aspirates from Breast Carcinoma Diagnosed as DCIS or Invasive Carcinoma

Sauer

Garred²,

Lømo³

et al. 2006

Acta Cytologica

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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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The cytopathology of ductal carcinoma in situ of the breast. A detailed analysis of fine needle aspiration cytology of 58 cases compared with 101 invasive ductal carcinomas

Cited by 35 publications

References 21 publications

The Microscopic Complexities of C3 in Breast Cytology

The Microscopic Complexities of C3 in Breast Cytology

Assessing Invasion Criteria in Fine Needle Aspirates from Breast Carcinoma Diagnosed as DCIS or Invasive Carcinoma

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

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