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Fine needle aspiration cytology of papillary lesions of the breast: how accurate is the diagnosis?
J Clin Pathol. 2008 Aug; 61(8):945-9.JC

Abstract

BACKGROUND

Cytological diagnosis of mammary papillary lesions is difficult.

AIM

To review the previous cytology diagnosis of 23 papillomas and 11 papillary carcinomas and specific cytological features that may assist in differentiating these entities.

METHODS

The cytology preparations were reviewed for: (i) overall cellularity; (ii) epithelial cell ball devoid of fibrovascular cores; (iii) background single cells; and (iv) papillary fragments and their morphology.

RESULTS

The overall diagnostic accuracy was 59%, atypical rate was 24%, and the error (combined false positive and negative) rate was 17%. For overall cellularity, 6, 14 and 3 cases of papillomas, and 6, 3 and 2 cases of papillary carcinomas showed low, moderate and high cellularity, respectively. Cell balls were present in mild to moderate number in 20 papillomas and 10 papillary carcinomas. The background single cells were absent, or present in low or moderate to high numbers in 7, 10 and 6 papillomas, and 3, 3 and 5 papillary carcinomas, respectively. Papillary fragments were absent, or present in small, moderate or large quantities in 9, 4, 8 and 2 papillomas, and 6, 3, 1 and 1 papillary carcinomas, respectively. There was no demonstrable quantitative difference between papilloma and papillary carcinoma for all these parameters. Qualitatively, the cell balls and single cells showed a higher degree of atypia in papillary carcinoma, and the papillary fragments were more elaborate and slender.

CONCLUSION

Cytological diagnosis of papillary lesions shows a significant error rate with overlapping features. Cellular atypia and fragments with long and slender papillae with ramifying edges favour papillary carcinoma.

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Authors+Show Affiliations

Tse GM
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong. garytse@cuhk.edu.hk
Ma TK
No affiliation info available
Lui PC
No affiliation info available
Ng DC
No affiliation info available
Yu AM
No affiliation info available
Vong JS
No affiliation info available
Niu Y
No affiliation info available
Chaiwun B
No affiliation info available
Lam WW
No affiliation info available
Tan PH
No affiliation info available

MeSH

AdultAgedAged, 80 and overBiopsy, NeedleBreast NeoplasmsCarcinoma, PapillaryDiagnosis, DifferentialFemaleHumansMiddle AgedPapillomaSensitivity and Specificity

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

18552172

Citation

Tse, G M K., et al. "Fine Needle Aspiration Cytology of Papillary Lesions of the Breast: How Accurate Is the Diagnosis?" Journal of Clinical Pathology, vol. 61, no. 8, 2008, pp. 945-9.
Tse GM, Ma TK, Lui PC, et al. Fine needle aspiration cytology of papillary lesions of the breast: how accurate is the diagnosis? J Clin Pathol. 2008;61(8):945-9.
Tse, G. M., Ma, T. K., Lui, P. C., Ng, D. C., Yu, A. M., Vong, J. S., Niu, Y., Chaiwun, B., Lam, W. W., & Tan, P. H. (2008). Fine needle aspiration cytology of papillary lesions of the breast: how accurate is the diagnosis? Journal of Clinical Pathology, 61(8), 945-9. https://doi.org/10.1136/jcp.2008.057489
Tse GM, et al. Fine Needle Aspiration Cytology of Papillary Lesions of the Breast: How Accurate Is the Diagnosis. J Clin Pathol. 2008;61(8):945-9. PubMed PMID: 18552172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fine needle aspiration cytology of papillary lesions of the breast: how accurate is the diagnosis? AU - Tse,G M K, AU - Ma,T K F, AU - Lui,P C W, AU - Ng,D C H, AU - Yu,A M C, AU - Vong,J S L, AU - Niu,Y, AU - Chaiwun,B, AU - Lam,W W M, AU - Tan,P H, Y1 - 2008/06/13/ PY - 2008/6/17/pubmed PY - 2008/8/21/medline PY - 2008/6/17/entrez SP - 945 EP - 9 JF - Journal of clinical pathology JO - J Clin Pathol VL - 61 IS - 8 N2 - BACKGROUND: Cytological diagnosis of mammary papillary lesions is difficult. AIM: To review the previous cytology diagnosis of 23 papillomas and 11 papillary carcinomas and specific cytological features that may assist in differentiating these entities. METHODS: The cytology preparations were reviewed for: (i) overall cellularity; (ii) epithelial cell ball devoid of fibrovascular cores; (iii) background single cells; and (iv) papillary fragments and their morphology. RESULTS: The overall diagnostic accuracy was 59%, atypical rate was 24%, and the error (combined false positive and negative) rate was 17%. For overall cellularity, 6, 14 and 3 cases of papillomas, and 6, 3 and 2 cases of papillary carcinomas showed low, moderate and high cellularity, respectively. Cell balls were present in mild to moderate number in 20 papillomas and 10 papillary carcinomas. The background single cells were absent, or present in low or moderate to high numbers in 7, 10 and 6 papillomas, and 3, 3 and 5 papillary carcinomas, respectively. Papillary fragments were absent, or present in small, moderate or large quantities in 9, 4, 8 and 2 papillomas, and 6, 3, 1 and 1 papillary carcinomas, respectively. There was no demonstrable quantitative difference between papilloma and papillary carcinoma for all these parameters. Qualitatively, the cell balls and single cells showed a higher degree of atypia in papillary carcinoma, and the papillary fragments were more elaborate and slender. CONCLUSION: Cytological diagnosis of papillary lesions shows a significant error rate with overlapping features. Cellular atypia and fragments with long and slender papillae with ramifying edges favour papillary carcinoma. SN - 1472-4146 UR - https://www.unboundmedicine.com/medline/citation/18552172/Fine_needle_aspiration_cytology_of_papillary_lesions_of_the_breast:_how_accurate_is_the_diagnosis L2 - https://jcp.bmj.com/lookup/pmidlookup?view=long&pmid=18552172 DB - PRIME DP - Unbound Medicine ER -