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The significance of extracellular mucin in breast fine needle aspiration specimens.
Cytopathology. 2016 Jun; 27(3):185-92.C

Abstract

OBJECTIVE

To determine if all breast fine needle aspiration (FNA) specimens with abundant extracellular mucin require excisional biopsy.

METHODS

Fifty cases of breast FNA containing extracellular mucin, reported with a recommendation for biopsy and with histological follow-up were reviewed. Cellular features were noted, and the cases reclassified ignoring the presence of mucin and then correlated with histological outcome.

RESULTS

Subsequent histology showed benign changes in 20% (10/50), two cases (4%) of atypical ductal hyperplasia (ADH) and 76% (38/50) to be malignant lesions, including three cases of ductal carcinoma in situ (DCIS). When the FNA cases were reviewed disregarding the presence of mucin, 11 cases were reclassified as benign and one case that contained mucin-like material but no epithelial cells reviewed as non-diagnostic. All cases of invasive mixed and mucinous carcinoma (MC) would have been reported with a recommendation for histological examination. In addition, the three cases each of fibroadenoma (FA) and a benign mucocoele-like lesion (MLL) were correctly identified as benign. However, two cases each of DCIS and ADH would have been reported benign with no recommendation for further histology.

CONCLUSIONS

Breast FNA specimens with mucinous material may arise from sampling of a range of benign and malignant processes; however, a biopsy should be recommended, even in cases of low cellularity, owing to sampling problems and the frequent co-occurrence of significant lesions. FNA is highly accurate at predicting carcinoma with mucinous differentiation although it is not possible to reliably predict if the lesion represents pure MC or a mixed carcinoma.

Authors+Show Affiliations

School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Qld, Australia. Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia.Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia.Cytology Department, Sullivan Nicolaides Pathology, Brisbane, Qld, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26104545

Citation

Shield, P W., et al. "The Significance of Extracellular Mucin in Breast Fine Needle Aspiration Specimens." Cytopathology : Official Journal of the British Society for Clinical Cytology, vol. 27, no. 3, 2016, pp. 185-92.
Shield PW, Ribu DL, Cominos D. The significance of extracellular mucin in breast fine needle aspiration specimens. Cytopathology. 2016;27(3):185-92.
Shield, P. W., Ribu, D. L., & Cominos, D. (2016). The significance of extracellular mucin in breast fine needle aspiration specimens. Cytopathology : Official Journal of the British Society for Clinical Cytology, 27(3), 185-92. https://doi.org/10.1111/cyt.12257
Shield PW, Ribu DL, Cominos D. The Significance of Extracellular Mucin in Breast Fine Needle Aspiration Specimens. Cytopathology. 2016;27(3):185-92. PubMed PMID: 26104545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The significance of extracellular mucin in breast fine needle aspiration specimens. AU - Shield,P W, AU - Ribu,D L, AU - Cominos,D, Y1 - 2015/06/24/ PY - 2015/02/15/accepted PY - 2015/6/25/entrez PY - 2015/6/25/pubmed PY - 2017/3/14/medline KW - breast KW - carcinoma KW - colloid adenocarcinoma KW - fine-needle aspiration KW - mucinous SP - 185 EP - 92 JF - Cytopathology : official journal of the British Society for Clinical Cytology JO - Cytopathology VL - 27 IS - 3 N2 - OBJECTIVE: To determine if all breast fine needle aspiration (FNA) specimens with abundant extracellular mucin require excisional biopsy. METHODS: Fifty cases of breast FNA containing extracellular mucin, reported with a recommendation for biopsy and with histological follow-up were reviewed. Cellular features were noted, and the cases reclassified ignoring the presence of mucin and then correlated with histological outcome. RESULTS: Subsequent histology showed benign changes in 20% (10/50), two cases (4%) of atypical ductal hyperplasia (ADH) and 76% (38/50) to be malignant lesions, including three cases of ductal carcinoma in situ (DCIS). When the FNA cases were reviewed disregarding the presence of mucin, 11 cases were reclassified as benign and one case that contained mucin-like material but no epithelial cells reviewed as non-diagnostic. All cases of invasive mixed and mucinous carcinoma (MC) would have been reported with a recommendation for histological examination. In addition, the three cases each of fibroadenoma (FA) and a benign mucocoele-like lesion (MLL) were correctly identified as benign. However, two cases each of DCIS and ADH would have been reported benign with no recommendation for further histology. CONCLUSIONS: Breast FNA specimens with mucinous material may arise from sampling of a range of benign and malignant processes; however, a biopsy should be recommended, even in cases of low cellularity, owing to sampling problems and the frequent co-occurrence of significant lesions. FNA is highly accurate at predicting carcinoma with mucinous differentiation although it is not possible to reliably predict if the lesion represents pure MC or a mixed carcinoma. SN - 1365-2303 UR - https://www.unboundmedicine.com/medline/citation/26104545/The_significance_of_extracellular_mucin_in_breast_fine_needle_aspiration_specimens_ L2 - https://doi.org/10.1111/cyt.12257 DB - PRIME DP - Unbound Medicine ER -