The spectrum of cytologic features in nonproliferative breast lesions

• Published in: Cancer Vol. 93; no. 2; pp. 140 - 145
• Main Authors: Sidawy, Mary K., Tabbara, Sana O., Bryan, John A., Poprocky, Linda A., Frost, Andra R.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 25.04.2001; Wiley-Liss
• Subjects: Adult; Aged; benign; Biological and medical sciences; Biopsy, Needle; breast; Breast - pathology; Cell Nucleus - pathology; cytology; Female; fibrocystic change; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; nonproliferative breast; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; proliferative breast disease; Human; Pathology; Mammary gland diseases; Metaplasia; Fibrosis; Cyst; Cytopathology; Benign neoplasm; Diagnosis; Mammary gland; Ectasia
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.9020

BACKGROUND The reliability of cytologic criteria to classify nonproliferative breast lesions (NPBL) is still debated. Sampling error and heterogeneity of breast lesions complicates the histologic correlation of fine‐needle aspiration results further. METHODS To provide optimal cytohistologic correlation, two smears (one that was stained with hematoxylin and eosin and one that was stained with Diff‐Quik [American Scientific Products, McGraw Park, IL]) were prepared from specific tissue sections from breast biopsies without mass lesions. The 42 cases classified as NPBL histologically were included in the current study. The cytologic features of the smears were evaluated. RESULTS Cellularity ranged from low (40% of cases) to moderate (50% of cases) to high (7% of cases). The cells were arranged in small clusters in 79% of cases, were mixed with large sheets in 17% of cases, and were in large sheets in 2% of cases. Intact lobules were noted in 31%. The configuration of the epithelial groups was complex in 62% of cases. Myoepithelial cells in the background and within the epithelial groups were noted in all the specimens. The percentage of single epithelial cells was < 10 in 38% of cases, 10–20 in 41%, and 20–30 in 19%. Mild nuclear enlargement and overlap, micronucleoli, and mild chromatin clumping were noted in a significant number of cases. CONCLUSIONS NPBL have been found to have a wide spectrum of cytologic appearances. At one end of the spectrum, smears are cellular with up to 30% single cells and large sheets in a complex configuration and exhibit nuclear enlargement and overlap and prominent nucleoli, features that overlap with those described in proliferative breast lesions. Cancer (Cancer Cytopathol) 2001;93:140–145. © 2001 American Cancer Society. Nonproliferative breast lesions present with a spectrum of cytologic appearances. At one end of the spectrum, the smears are cellular with up to 30% single cells, nuclear enlargement, nuclear overlap, and prominent nucleoli. These features may overlap with those of proliferative breast lesions.