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Atypical and suspicious categories in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance.
Singapore Med J. 2005 Dec; 46(12):706-9.SM

Abstract

INTRODUCTION

This study aims to correlate fine-needle aspiration specimens diagnosed as C3 (atypical, probably benign) and C4 (suspicious, probably malignant) with histology and mammography, and to evaluate these two cytology categories in terms of diagnostic usefulness and patient management.

METHODS

All fine-needle aspiration (FNA) specimens in categories C3 or C4 at the Maharaj Nakorn Chiang Mai Hospital, Thailand between 2000-2004 were reviewed. Results were correlated with available histological and mammographical studies.

RESULTS

148 FNA specimens were identified, comprising 43 category C3 and 105 category C4. Histology was available in 90 cases. 14 (64 percent) C3 cases showed benign histology on biopsy and eight (36 percent) were malignant. 13 (19 percent) C4 cases were benign on biopsy, whereas 55 (81 percent) were malignant. Mammographical studies were available in 56 of the histologically-proven cases. All seven cases with benign mammograms had benign histology, and all 26 cases called "highly suggestive of malignancy" were malignant on histology (five C3 and 21 C4). Of the 23 cases called "suspicious abnormality" on mammography, 14 turned out to be malignant on biopsy (one C3 and 13 C4).

CONCLUSION

Our study supports maintaining cytology categories C3 and C4. About two-thirds of C3 cases were benign on biopsy whereas 81 percent of C4 cases were malignant (p-value is less than 0.001). There was complete correlation between histological and mammographical studies except those with equivocal mammograms. Our study supports the combined use of clinical, mammographical and cytological findings for optimal patient management. This is especially important for patients with C3 aspiration results, in order to avoid unnecessary surgery for benign lesions.

Authors+Show Affiliations

Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. bchaiwun@mail.med.cmu.ac.thNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

16308644

Citation

Chaiwun, B, et al. "Atypical and Suspicious Categories in Fine Needle Aspiration Cytology of the Breast: Histological and Mammographical Correlation and Clinical Significance." Singapore Medical Journal, vol. 46, no. 12, 2005, pp. 706-9.
Chaiwun B, Sukhamwang N, Lekawanvijit S, et al. Atypical and suspicious categories in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance. Singapore Med J. 2005;46(12):706-9.
Chaiwun, B., Sukhamwang, N., Lekawanvijit, S., Sukapan, K., Rangdaeng, S., Muttarak, M., & Thorner, P. S. (2005). Atypical and suspicious categories in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance. Singapore Medical Journal, 46(12), 706-9.
Chaiwun B, et al. Atypical and Suspicious Categories in Fine Needle Aspiration Cytology of the Breast: Histological and Mammographical Correlation and Clinical Significance. Singapore Med J. 2005;46(12):706-9. PubMed PMID: 16308644.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atypical and suspicious categories in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance. AU - Chaiwun,B, AU - Sukhamwang,N, AU - Lekawanvijit,S, AU - Sukapan,K, AU - Rangdaeng,S, AU - Muttarak,M, AU - Thorner,P S, PY - 2005/11/26/pubmed PY - 2006/1/27/medline PY - 2005/11/26/entrez SP - 706 EP - 9 JF - Singapore medical journal JO - Singapore Med J VL - 46 IS - 12 N2 - INTRODUCTION: This study aims to correlate fine-needle aspiration specimens diagnosed as C3 (atypical, probably benign) and C4 (suspicious, probably malignant) with histology and mammography, and to evaluate these two cytology categories in terms of diagnostic usefulness and patient management. METHODS: All fine-needle aspiration (FNA) specimens in categories C3 or C4 at the Maharaj Nakorn Chiang Mai Hospital, Thailand between 2000-2004 were reviewed. Results were correlated with available histological and mammographical studies. RESULTS: 148 FNA specimens were identified, comprising 43 category C3 and 105 category C4. Histology was available in 90 cases. 14 (64 percent) C3 cases showed benign histology on biopsy and eight (36 percent) were malignant. 13 (19 percent) C4 cases were benign on biopsy, whereas 55 (81 percent) were malignant. Mammographical studies were available in 56 of the histologically-proven cases. All seven cases with benign mammograms had benign histology, and all 26 cases called "highly suggestive of malignancy" were malignant on histology (five C3 and 21 C4). Of the 23 cases called "suspicious abnormality" on mammography, 14 turned out to be malignant on biopsy (one C3 and 13 C4). CONCLUSION: Our study supports maintaining cytology categories C3 and C4. About two-thirds of C3 cases were benign on biopsy whereas 81 percent of C4 cases were malignant (p-value is less than 0.001). There was complete correlation between histological and mammographical studies except those with equivocal mammograms. Our study supports the combined use of clinical, mammographical and cytological findings for optimal patient management. This is especially important for patients with C3 aspiration results, in order to avoid unnecessary surgery for benign lesions. SN - 0037-5675 UR - https://www.unboundmedicine.com/medline/citation/16308644/Atypical_and_suspicious_categories_in_fine_needle_aspiration_cytology_of_the_breast:_histological_and_mammographical_correlation_and_clinical_significance_ L2 - http://www.sma.org.sg/smj/4612/4612a4.pdf DB - PRIME DP - Unbound Medicine ER -