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Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology?
Cancer. 2002 Apr 25; 96(2):92-100.C

Abstract

BACKGROUND

The cytologic accuracy in assessing malignancy in papillary breast neoplasms (PBNs) is controversial. This is further complicated by overlapping features observed in other breast lesions that produce papillary-like tissue fragments.

METHODS

The authors reviewed 22 fine-needle aspirates (FNAs) from histologically proven papillary neoplasms: papillary carcinoma (PCA; 10 aspirates) and intraductal papilloma (IDP; 12 aspirates). They also reviewed 8 FNAs in which a papillary neoplasm was suggested by cytology but not confirmed by follow-up biopsy: fibroadenoma (6), mucinous carcinoma (1), and cribriform ductal carcinoma in situ (1).

RESULTS

Papillary carcinoma can be distinguished from IDP by the higher cellularity, more complex papillae with thin disorganized fronds, mild to moderate nuclear atypia, and prominent dissociation with many single papillae. Fibrovascular cores (FVCs) were more common in PCA than IDP in which detached fibrous tissue fragments were frequently seen. Atypical IDP exhibited features intermediate between PCA and IDP. Apocrine metaplasia was variably present in IDP, atypical IDP, and fibroadenoma but absent in all carcinomas. Intraductal papilloma can be distinguished from fibroadenoma by their broad ruffled branches, scalloped borders, and tiny tongue-like projections. True papillae were commonly covered by tall columnar cells. Myoepithelial cells were few in IDP but were numerous in fibroadenoma. The epithelial fragments in nonpapillary lesions presented as cellular spheres and/or complex sheets with finger-like projections but lacked FVCs and columnar cells.

CONCLUSIONS

Papillary breast neoplasms can be accurately classified by cytology. Closer evaluation of the tissue fragments architecture and the background can help in separating PBN from their mimics.

Authors+Show Affiliations

University of Michigan, Department of Pathology, Ann Arbor, Michigan 48105, USA. clairemi@med.umich.eduNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11954026

Citation

Michael, Claire W., and Bruce Buschmann. "Can True Papillary Neoplasms of Breast and Their Mimickers Be Accurately Classified By Cytology?" Cancer, vol. 96, no. 2, 2002, pp. 92-100.
Michael CW, Buschmann B. Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology? Cancer. 2002;96(2):92-100.
Michael, C. W., & Buschmann, B. (2002). Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology? Cancer, 96(2), 92-100.
Michael CW, Buschmann B. Can True Papillary Neoplasms of Breast and Their Mimickers Be Accurately Classified By Cytology. Cancer. 2002 Apr 25;96(2):92-100. PubMed PMID: 11954026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology? AU - Michael,Claire W, AU - Buschmann,Bruce, PY - 2002/4/16/pubmed PY - 2002/5/25/medline PY - 2002/4/16/entrez SP - 92 EP - 100 JF - Cancer JO - Cancer VL - 96 IS - 2 N2 - BACKGROUND: The cytologic accuracy in assessing malignancy in papillary breast neoplasms (PBNs) is controversial. This is further complicated by overlapping features observed in other breast lesions that produce papillary-like tissue fragments. METHODS: The authors reviewed 22 fine-needle aspirates (FNAs) from histologically proven papillary neoplasms: papillary carcinoma (PCA; 10 aspirates) and intraductal papilloma (IDP; 12 aspirates). They also reviewed 8 FNAs in which a papillary neoplasm was suggested by cytology but not confirmed by follow-up biopsy: fibroadenoma (6), mucinous carcinoma (1), and cribriform ductal carcinoma in situ (1). RESULTS: Papillary carcinoma can be distinguished from IDP by the higher cellularity, more complex papillae with thin disorganized fronds, mild to moderate nuclear atypia, and prominent dissociation with many single papillae. Fibrovascular cores (FVCs) were more common in PCA than IDP in which detached fibrous tissue fragments were frequently seen. Atypical IDP exhibited features intermediate between PCA and IDP. Apocrine metaplasia was variably present in IDP, atypical IDP, and fibroadenoma but absent in all carcinomas. Intraductal papilloma can be distinguished from fibroadenoma by their broad ruffled branches, scalloped borders, and tiny tongue-like projections. True papillae were commonly covered by tall columnar cells. Myoepithelial cells were few in IDP but were numerous in fibroadenoma. The epithelial fragments in nonpapillary lesions presented as cellular spheres and/or complex sheets with finger-like projections but lacked FVCs and columnar cells. CONCLUSIONS: Papillary breast neoplasms can be accurately classified by cytology. Closer evaluation of the tissue fragments architecture and the background can help in separating PBN from their mimics. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/11954026/Can_true_papillary_neoplasms_of_breast_and_their_mimickers_be_accurately_classified_by_cytology L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0008-543X&date=2002&volume=96&issue=2&spage=92 DB - PRIME DP - Unbound Medicine ER -