Cellular dyscohesion in fine-needle aspiration of breast carcinoma - Prognostic indicator for axillary lymph node metastases?

The role of fine-needle aspiration (FNA) in the diagnosis of breast carcino ma is established. We evaluated whether the degree of cellular dyscohesion and the nuclear grade in FNA material of breast carcinomas are reliable pro gnostic predictors for ipsilateral axillary lymph node metastasis. FNA spec imens from 98 women with infiltrating ductal and infiltrating lobular carci nomas were evaluated by 2 observers for degree of cellular dyscohesion and nuclear grade. Follow-up specimens from lumpectomy and/or mastectomy with a xillary dissection were available for each patient. By univariate analysis, degree of cellular dyscohesion and nuclear grade were not predictive of ax illary lymph node metastasis regardless of tumor size. High histologic grad e, size greater than 2 cm, and patient age younger than 52 years were signi ficant predictors of metastasis. By multivariate analysis, size greater tha n 2 cm and age younger than 52 years were statistically significant for lym ph node metastasis. In contrast with a published study, the results of the present study fail to show cellular dyscohesion in FNA specimens as predict ive of lymph node metastasis; however the scoring method for determining th e degree of cellular dyscohesion is reproducible between 2 independent obse rvers.