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Fine needle aspiration cytology of lobular breast carcinoma. Comparison with other breast lesions.
Acta Cytol. 2003 Mar-Apr; 47(2):177-82.AC

Abstract

OBJECTIVE

To analyze the detailed cytomorphology of lobular breast carcinoma and to compare the cytologic smears of benign, borderline and infiltrating duct carcinoma.

STUDY DESIGN

Fine needle aspiration cytology (FNAC) smears of histopathologically proven infiltrating lobular carcinoma (ILC), infiltrating ductal carcinoma (IDC), borderline lesions and benign breast lesions were selected for study. Detailed cytomorphologic analysis of the smears was carried out on hematoxylin and eosin- and May-Grünwald-Giemsa--stained slides, and a comparison of results was done. The various cytologic features were also graded semi-quantitatively with the numerical score; logistic regression analysis was done.

RESULTS

There were 25 cases of ILC, 30 of IDC, and 10 borderline and 18 benign lesions. Cytologic diagnosis of malignancy on FNAC smears of ILC was offered in 19 cases; of them, 2 cases were diagnosed as ILC. The remaining six cases were diagnosed as borderline (four) and benign lesions (two). Overall sensitivity in detection of malignancy in ILC cases was 76%. FNAC smears of ILC showed moderate (52%) to abundant (32%) cellularity. The cells of ILC were arranged both in clusters and in dissociation (72%). Individual cells were monomorphic (40%) to mildly pleomorphic (60%), and the cells were smaller. The cells showed a smooth, regular nuclear margin; bland chromatin; and indistinct nucleoli. Indian file arrangement was frequently observed (28%). Nuclear molding (28%) and intranuclear inclusions (16%) were also noted. Intracytoplasmic lumina were seen in occasional cases. Logistic regression analysis was carried out, and a comparison between lobular carcinoma and ductal carcinoma, and borderline and benign lesions was done. Logistic regression analysis of cytomorphologic features showed that cellularity and nuclear margin irregularities were the two most important features to distinguish ILC from IDC. In comparison to borderline lesions, cell dissociation was more common in ILC. The salient cytologic features that helped to distinguish ILC from benign lesions was cell size, cellularity, cell uniformity and chromatin pattern.

CONCLUSION

There are overlapping cytologic features between ILC, IDC and borderline breast lesions on FNAC smears. Logistic regression analysis may be helpful in this regard.

Authors+Show Affiliations

Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh-160012 India.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12685185

Citation

Rajesh, Logasundaram, et al. "Fine Needle Aspiration Cytology of Lobular Breast Carcinoma. Comparison With Other Breast Lesions." Acta Cytologica, vol. 47, no. 2, 2003, pp. 177-82.
Rajesh L, Dey P, Joshi K. Fine needle aspiration cytology of lobular breast carcinoma. Comparison with other breast lesions. Acta Cytol. 2003;47(2):177-82.
Rajesh, L., Dey, P., & Joshi, K. (2003). Fine needle aspiration cytology of lobular breast carcinoma. Comparison with other breast lesions. Acta Cytologica, 47(2), 177-82.
Rajesh L, Dey P, Joshi K. Fine Needle Aspiration Cytology of Lobular Breast Carcinoma. Comparison With Other Breast Lesions. Acta Cytol. 2003 Mar-Apr;47(2):177-82. PubMed PMID: 12685185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fine needle aspiration cytology of lobular breast carcinoma. Comparison with other breast lesions. AU - Rajesh,Logasundaram, AU - Dey,Pranab, AU - Joshi,Kusum, PY - 2003/4/11/pubmed PY - 2003/5/31/medline PY - 2003/4/11/entrez SP - 177 EP - 82 JF - Acta cytologica JO - Acta Cytol VL - 47 IS - 2 N2 - OBJECTIVE: To analyze the detailed cytomorphology of lobular breast carcinoma and to compare the cytologic smears of benign, borderline and infiltrating duct carcinoma. STUDY DESIGN: Fine needle aspiration cytology (FNAC) smears of histopathologically proven infiltrating lobular carcinoma (ILC), infiltrating ductal carcinoma (IDC), borderline lesions and benign breast lesions were selected for study. Detailed cytomorphologic analysis of the smears was carried out on hematoxylin and eosin- and May-Grünwald-Giemsa--stained slides, and a comparison of results was done. The various cytologic features were also graded semi-quantitatively with the numerical score; logistic regression analysis was done. RESULTS: There were 25 cases of ILC, 30 of IDC, and 10 borderline and 18 benign lesions. Cytologic diagnosis of malignancy on FNAC smears of ILC was offered in 19 cases; of them, 2 cases were diagnosed as ILC. The remaining six cases were diagnosed as borderline (four) and benign lesions (two). Overall sensitivity in detection of malignancy in ILC cases was 76%. FNAC smears of ILC showed moderate (52%) to abundant (32%) cellularity. The cells of ILC were arranged both in clusters and in dissociation (72%). Individual cells were monomorphic (40%) to mildly pleomorphic (60%), and the cells were smaller. The cells showed a smooth, regular nuclear margin; bland chromatin; and indistinct nucleoli. Indian file arrangement was frequently observed (28%). Nuclear molding (28%) and intranuclear inclusions (16%) were also noted. Intracytoplasmic lumina were seen in occasional cases. Logistic regression analysis was carried out, and a comparison between lobular carcinoma and ductal carcinoma, and borderline and benign lesions was done. Logistic regression analysis of cytomorphologic features showed that cellularity and nuclear margin irregularities were the two most important features to distinguish ILC from IDC. In comparison to borderline lesions, cell dissociation was more common in ILC. The salient cytologic features that helped to distinguish ILC from benign lesions was cell size, cellularity, cell uniformity and chromatin pattern. CONCLUSION: There are overlapping cytologic features between ILC, IDC and borderline breast lesions on FNAC smears. Logistic regression analysis may be helpful in this regard. SN - 0001-5547 UR - https://www.unboundmedicine.com/medline/citation/12685185/Fine_needle_aspiration_cytology_of_lobular_breast_carcinoma__Comparison_with_other_breast_lesions_ L2 - https://www.karger.com?DOI=10.1159/000326500 DB - PRIME DP - Unbound Medicine ER -