THE VALUE OF FINE-NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF BREAST PROLIFERATIVE LESIONS

In order to further characterize fine needle aspiration cytology of br east proliferative lesions, we analyzed 723 FNA of patients with palpa ble breast abnormalities who underwent physical, mammographic and/or e chographic examination. In 28 biopsies (3.9%), the final cytologic dia gnosis was a proliferative lesion, a group of uncommon breast prolifer ative diseases not yet explored, in which cytology is sufficiently cel lular with plenty of atypical elements but not suspicious of carcinoma . Histologic material was available in 22 cases and represented the ba sis of this retrospective evaluation. Among the positive proliferative lesions (PPL), 10 cases were infiltrating ductal carcinomas and 1 was a microinvasive carcinoma; whereas for the negative proliferative les ions (NPL), in 8 cases the histologic findings demonstrated fibrocysti c changes, in 1 a fibroadenoma and in 1 a cystosarcoma phyllodes. The cytologic criteria utilized to define breast proliferative lesions wer e the following: increased cellularity, occasional single atypical cel ls, decreased cellular cohesion, crowded, enlarged and overlapping nuc lei with three dimensional groupings with prominent nucleoli and chrom atic changes. The cytologic characteristics by single atypical cells w ith nuclear alterations such as coarsely granular chromatin with a thi ck nuclear membrane and numerous prominent nucleoli. These features ar e common to many malignancies, therefore surgical biopsy confirmation is suggested.