LOBULAR CARCINOMA OF THE BREAST - CYTOLOGICAL FEATURES SUPPORTING THEDIAGNOSIS OF LOBULAR CANCER

Lobular carcinomas have a distinct natural history with a better respo nse to endocrine therapy and a higher incidence of local recurrence an d are more often bilateral The cytological diagnosis of lobular carcin oma permits a discriminating therapeutic approach with pre-operative T amoxifen, more generous resection margins, and assessment of the contr alateral breast. The cytological features of lobular cancer however ar e nor well defined and the low cell yield from such neoplasms can resu lt in a high false negative rate. To determine whether we could improv e the pre-operative diagnosis, we reviewed the cytological features of 112 lobular carcinomas. They had small uniform sized nuclei with irre gular outlines and inconspicuous nucleoli. The degree of dissociation was similar to duct carcinomas and the incidence of inadequate aspirat es was no higher. We found no features that confidently diagnosed lobu lar cancer or its sub-types. However, using a combination of features, typing of lobular cancer on aspirated material is possible and should be attempted. (C) 1995 Wiley-Liss, Inc.