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Value of scoring system in classification of proliferative breast disease on fine needle aspiration cytology.
Indian J Pathol Microbiol. 2006 Jul; 49(3):334-40.IJ

Abstract

Fine-needle aspiration (FNA) cytology is successful in identification of benign and malignant breast lesions, but its role in proliferative breast lesions which increase cancer risk is poorly defined. We have analyzed the cytomorphologic features of proliferative breast lesions in conjunction with cytologic scoring system proposed by Masood et al and with histopathology. Sixty two patients (14 cases of fibroadenoma, 15 cases of fibroadenoma with atypia, 11 cases of proliferative breast disease (PBD), 8 cases of PBD with atypia and 14 cases of carcinoma) diagnosed on routine FNA were subjected to scoring following Masood's criteria. All cases with the cytologic diagnosis of fibroadenoma were confirmed on histology. Of 11 cases of PBD on FNA, 10 were PBD without atypia on histology. One case, which showed atypical hyperplasia on histology, was missed by both the scoring system and cytomorphology and one case was over-diagnosed as PBD with atypia by the scoring system. FNA cytology correctly identified all the carcinoma cases, while the scoring system under-diagnosed 2 cases as PBD with atypia. Hence, in cases not suspected to be atypical or confirmed to be cancer on routine cytology, scoring added no information over and above cytomorphology and was not useful. All fourteen cases of fibroadenoma with atypia suspected on routine cytology were fibroadenoma on histology. Scoring system correctly placed 11/14 of these cases as PBD without atypia. Similarly 3/8 cases thought to be PBD with atypia were correctly placed as PBD without atypia by scoring. Only 2/8 cases thought to be PBD with atypia on cytology were confirmed to have atypical hyperplasia on histology. Scoring improved the diagnostic yield to 2/5. Hence, in cases of fibroadenoma or PBD, suspected on FNAC to have cytological atypia, Masood scoring gives additional information by eliminating benign cases and improving diagnostic yield. Application of scoring in a step-wise manner, on atypical aspirates, can help in selection of cases suitable for biopsy.

Authors+Show Affiliations

Department of Pathology, All India Institute of Medical Sciences, New Delhi.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17001879

Citation

Mridha, Asit Ranjan, et al. "Value of Scoring System in Classification of Proliferative Breast Disease On Fine Needle Aspiration Cytology." Indian Journal of Pathology & Microbiology, vol. 49, no. 3, 2006, pp. 334-40.
Mridha AR, Iyer VK, Kapila K, et al. Value of scoring system in classification of proliferative breast disease on fine needle aspiration cytology. Indian J Pathol Microbiol. 2006;49(3):334-40.
Mridha, A. R., Iyer, V. K., Kapila, K., & Verma, K. (2006). Value of scoring system in classification of proliferative breast disease on fine needle aspiration cytology. Indian Journal of Pathology & Microbiology, 49(3), 334-40.
Mridha AR, et al. Value of Scoring System in Classification of Proliferative Breast Disease On Fine Needle Aspiration Cytology. Indian J Pathol Microbiol. 2006;49(3):334-40. PubMed PMID: 17001879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Value of scoring system in classification of proliferative breast disease on fine needle aspiration cytology. AU - Mridha,Asit Ranjan, AU - Iyer,Venkateswaran K, AU - Kapila,Kusum, AU - Verma,Kusum, PY - 2006/9/28/pubmed PY - 2006/10/25/medline PY - 2006/9/28/entrez SP - 334 EP - 40 JF - Indian journal of pathology & microbiology JO - Indian J Pathol Microbiol VL - 49 IS - 3 N2 - Fine-needle aspiration (FNA) cytology is successful in identification of benign and malignant breast lesions, but its role in proliferative breast lesions which increase cancer risk is poorly defined. We have analyzed the cytomorphologic features of proliferative breast lesions in conjunction with cytologic scoring system proposed by Masood et al and with histopathology. Sixty two patients (14 cases of fibroadenoma, 15 cases of fibroadenoma with atypia, 11 cases of proliferative breast disease (PBD), 8 cases of PBD with atypia and 14 cases of carcinoma) diagnosed on routine FNA were subjected to scoring following Masood's criteria. All cases with the cytologic diagnosis of fibroadenoma were confirmed on histology. Of 11 cases of PBD on FNA, 10 were PBD without atypia on histology. One case, which showed atypical hyperplasia on histology, was missed by both the scoring system and cytomorphology and one case was over-diagnosed as PBD with atypia by the scoring system. FNA cytology correctly identified all the carcinoma cases, while the scoring system under-diagnosed 2 cases as PBD with atypia. Hence, in cases not suspected to be atypical or confirmed to be cancer on routine cytology, scoring added no information over and above cytomorphology and was not useful. All fourteen cases of fibroadenoma with atypia suspected on routine cytology were fibroadenoma on histology. Scoring system correctly placed 11/14 of these cases as PBD without atypia. Similarly 3/8 cases thought to be PBD with atypia were correctly placed as PBD without atypia by scoring. Only 2/8 cases thought to be PBD with atypia on cytology were confirmed to have atypical hyperplasia on histology. Scoring improved the diagnostic yield to 2/5. Hence, in cases of fibroadenoma or PBD, suspected on FNAC to have cytological atypia, Masood scoring gives additional information by eliminating benign cases and improving diagnostic yield. Application of scoring in a step-wise manner, on atypical aspirates, can help in selection of cases suitable for biopsy. SN - 0377-4929 UR - https://www.unboundmedicine.com/medline/citation/17001879/Value_of_scoring_system_in_classification_of_proliferative_breast_disease_on_fine_needle_aspiration_cytology_ L2 - https://medlineplus.gov/breastdiseases.html DB - PRIME DP - Unbound Medicine ER -