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Stereotaxic fine needle aspiration cytology of clinically occult malignant and premalignant breast lesions.
Acta Cytol. 1988 Mar-Apr; 32(2):193-201.AC

Abstract

Stereotaxic fine needle aspiration (FNA) cytology was used to study clinically occult (nonpalpable) breast lesions in 114 consecutive patients with mammographically suspicious findings prior to excisional biopsy. The aspirate contained insufficient material for cytologic evaluation in 15 cases (13.2%), which were histologically diagnosed as benign (7 cases), atypical hyperplasia (7 cases) or carcinoma in situ (1 case). The cytologic findings indicated a benign lesion in 77 cases (67.5%), which were histologically diagnosed as benign (71 cases) or atypical ductal hyperplasia (6 cases). The cytologic sample showed atypia in eight cases (7.0%), which were histologically diagnosed as severe atypical ductal hyperplasia (three cases), carcinoma in situ (one case) or proliferative fibrocystic disease (four cases). In the eight cases (7.0%) cytologically interpreted as probably malignant, histology confirmed six invasive carcinomas, one carcinoma in situ and one fibrocystic disease. Of six cases (4.4%) cytologically reported as malignant, five were histologically diagnosed as invasive carcinoma and one as carcinoma in situ. Overall, stereotaxic FNA cytology reported as malignant or probably malignant 14 of the 15 cases with a histologic confirmation of malignancy, for a sensitivity of 93.3%. Cytology correctly identified 78 of the 83 histologically negative cases, for a specificity of 94.0%. The 16 cases histologically diagnosed as ductal hyperplasia, which carries a high risk for subsequent malignancy, were studied in detail in an effort to define histologic and cytologic criteria for this entity. Using selected histologic criteria, 11 of these cases were graded as showing mild-to-moderate atypical hyperplasia and 5 as showing severe atypical hyperplasia. Three of the latter cases were similarly identified by an analogous cytologic grading; the other two cases had insufficient cytologic samples. The total results in this series of 114 cases support the use of stereotaxic FNA cytology in the diagnosis of these nonpalpable breast lesions, examples of which are illustrated. In particular, it may help to raise the low specificity yielded by mammography alone, which would represent a significant advance for the patient in terms of the accuracy, expediency and reduced cost of diagnosing these lesions.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, University of Chicago, Illinois 60637.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2831687

Citation

Bibbo, M, et al. "Stereotaxic Fine Needle Aspiration Cytology of Clinically Occult Malignant and Premalignant Breast Lesions." Acta Cytologica, vol. 32, no. 2, 1988, pp. 193-201.
Bibbo M, Scheiber M, Cajulis R, et al. Stereotaxic fine needle aspiration cytology of clinically occult malignant and premalignant breast lesions. Acta Cytol. 1988;32(2):193-201.
Bibbo, M., Scheiber, M., Cajulis, R., Keebler, C. M., Wied, G. L., & Dowlatshahi, K. (1988). Stereotaxic fine needle aspiration cytology of clinically occult malignant and premalignant breast lesions. Acta Cytologica, 32(2), 193-201.
Bibbo M, et al. Stereotaxic Fine Needle Aspiration Cytology of Clinically Occult Malignant and Premalignant Breast Lesions. Acta Cytol. 1988 Mar-Apr;32(2):193-201. PubMed PMID: 2831687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stereotaxic fine needle aspiration cytology of clinically occult malignant and premalignant breast lesions. AU - Bibbo,M, AU - Scheiber,M, AU - Cajulis,R, AU - Keebler,C M, AU - Wied,G L, AU - Dowlatshahi,K, PY - 1988/3/1/pubmed PY - 1988/3/1/medline PY - 1988/3/1/entrez SP - 193 EP - 201 JF - Acta cytologica JO - Acta Cytol VL - 32 IS - 2 N2 - Stereotaxic fine needle aspiration (FNA) cytology was used to study clinically occult (nonpalpable) breast lesions in 114 consecutive patients with mammographically suspicious findings prior to excisional biopsy. The aspirate contained insufficient material for cytologic evaluation in 15 cases (13.2%), which were histologically diagnosed as benign (7 cases), atypical hyperplasia (7 cases) or carcinoma in situ (1 case). The cytologic findings indicated a benign lesion in 77 cases (67.5%), which were histologically diagnosed as benign (71 cases) or atypical ductal hyperplasia (6 cases). The cytologic sample showed atypia in eight cases (7.0%), which were histologically diagnosed as severe atypical ductal hyperplasia (three cases), carcinoma in situ (one case) or proliferative fibrocystic disease (four cases). In the eight cases (7.0%) cytologically interpreted as probably malignant, histology confirmed six invasive carcinomas, one carcinoma in situ and one fibrocystic disease. Of six cases (4.4%) cytologically reported as malignant, five were histologically diagnosed as invasive carcinoma and one as carcinoma in situ. Overall, stereotaxic FNA cytology reported as malignant or probably malignant 14 of the 15 cases with a histologic confirmation of malignancy, for a sensitivity of 93.3%. Cytology correctly identified 78 of the 83 histologically negative cases, for a specificity of 94.0%. The 16 cases histologically diagnosed as ductal hyperplasia, which carries a high risk for subsequent malignancy, were studied in detail in an effort to define histologic and cytologic criteria for this entity. Using selected histologic criteria, 11 of these cases were graded as showing mild-to-moderate atypical hyperplasia and 5 as showing severe atypical hyperplasia. Three of the latter cases were similarly identified by an analogous cytologic grading; the other two cases had insufficient cytologic samples. The total results in this series of 114 cases support the use of stereotaxic FNA cytology in the diagnosis of these nonpalpable breast lesions, examples of which are illustrated. In particular, it may help to raise the low specificity yielded by mammography alone, which would represent a significant advance for the patient in terms of the accuracy, expediency and reduced cost of diagnosing these lesions. SN - 0001-5547 UR - https://www.unboundmedicine.com/medline/citation/2831687/Stereotaxic_fine_needle_aspiration_cytology_of_clinically_occult_malignant_and_premalignant_breast_lesions_ L2 - https://medlineplus.gov/breastcancer.html DB - PRIME DP - Unbound Medicine ER -