Mature breast disease


No atypical or malignant features are present. Among the solid breast lesions, fibroadenoma is most common especially in women who are less than 40 years old. Most often, it is the degree of cellularity of the epithelial cells that is inadequate [ 2 ] Figure 1. Exceptions occur in cystic and fibrotic lesions that are inevitably hypocellular. This problem arises when paucity of specimen sampling is encountered or there is a morphological overlap between benign and malignant lesions e. C3 presents the characteristics of a benign smear and yet there are features that are not usually seen in clearly benign specimens such as cellular crowding, pleomorphism, and discohesion. When these cytologic features are encountered, intraductal papilloma and fibroadenoma are some of the differentials that need to be ruled out. It is relatively common, accounting for 2. Currently, accurate diagnosis of breast lesions depends on a triple assessment approach comprising clinical, imaging and pathologic examinations. This categorization helps the cytopathologists to define the uncertain areas, and the clinicians to offer further investigation like excisional biopsy judiciously.
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Pathology Research International

Nipple discharge is one of the alarming complaints that would prompt patients to seek clinical consults. The accuracy of FNAC in diagnosing papillary lesions and differentiating benign and malignant papillary lesions is low [ 20 ]. The main problem associated with FNAC of nonpalpable lesions was the variable but sometimes unacceptably high rate [ 32 ] of inadequacy. C5 category consists of cellular aspirate with evidently malignant cytologic features. Attaining adequacy in the aspirates of these nonpalpable lesions poses greater challenge because of their small sizes in many cases, as well as the presence of fibrotic component. Thus, each procedure should be patterned and restricted to clinically and radiologically appropriate scenarios [ 2 ].
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When these cytologic features are encountered, intraductal papilloma and fibroadenoma are some of the differentials that need to be ruled out. Another potential source of confusion rises when there is the presence of proteinaceous fluid in the background, being associated with epithelial cells that are large, with enlarged nuclei, eosinophilic nucleoli, and vacuolated and wispy cytoplasm. Apocrine cells, when degenerated will most often appear atypical especially if it has progressed over time to the phase of chromatin clumping with associated anisonucleosis [ 2 ], and these could potentially be labeled as suspicious Figure 3. Cytologically, aspirates are hypercellular with characteristic monolayer sheets of benign-looking epithelial cells mixed with myoepithelial cells. The widespread adoption of breast screening and advances in imaging techniques also resulted in the detection of small lesions, and understandably, FNAC of these small lesions has a significant risk of missing these lesions, leading to potentially false-negative results.
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Description:Fibrocystic changes present a spectrum of histological features that may sometimes be associated with calcification. Inflammatory background is commonly encountered. The above findings of apocrine cells, macrophages, and ductal cells are the characteristic features of a nonproliferative type of fibrocystic changes, which yields only scanty materials. The added presence of large number of bipolar nuclei in the background of smear is a reliable feature in favor of fibroadenoma [ 2 ]. In addition, papillary fronds reminiscent of staghorn clusters can also be seen in papillomas. Another potential source of confusion rises when there is the presence of proteinaceous fluid in the background, being associated with epithelial cells that are large, with enlarged nuclei, eosinophilic nucleoli, and vacuolated and wispy cytoplasm. Abstract Currently, accurate diagnosis of breast lesions depends on a triple assessment approach comprising clinical, imaging and pathologic examinations. In the true false negative factors, the denominators are poor sampling technique, mislocalization of the tumor, or the presence of a well-defined tumor demonstrating minimal atypia [ 29 , 30 ]. This pattern reflects the configuration of ducts as observed on histological sections [ 2 , 16 ]. Some studies advocated that both aspirator and interpreter should ideally be the same, as the number of inadequate aspirates was far lower and the accuracy of diagnosis was higher when the same person aspirated and reported on the specimens [ 2 , 4 , 5 ].

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