Cancer · 2000
Cytologic features of proliferative breast disease: a study designed to minimize sampling error.
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Frost A R, Tabbara S O, Poprocky L A, Weiss H, Sidawy M K
Аннотация
BACKGROUND: Assessment of cytologic features that allow accurate classification of proliferative breast disease has been hampered by sampling errors when fine-needle aspirations have been compared with their corresponding histologic sections.
METHODS: To allow for optimal cytohistologic correlation, 2 smears (1 hematoxylin and eosin-stained and 1 Diff-Quik-stained) were prepared from each of 98 breast biopsies without mass lesions and compared with the corresponding histologic sections of the scraped area. Each smear was reviewed in a blinded fashion and assessed for cellularity, background elements, cytoarchitectural features of cell groups, and nuclear features by 2 reviewers. Smears were then classified as nonproliferative breast disease (NPBD), proliferative breast disease without atypia (PBD) or with atypia (PBDA), or DCIS, based on review of the corresponding histologic sections.
RESULTS: When comparing NPBD/PBD (n = 86) with PBDA/DCIS (n = 12), smears from PBDA/DCIS were significantly (by the Fisher exact test or Wilcoxon rank sum P values with adjustment for multiple comparisons) more likely to be cellular; contain single cells and necrosis; exhibit nuclear overlap and cytoplasmic vacuoles; have large nuclei, macronucleoli, pleomorphism, clumped chromatin, and hyperchromasia; and were less likely to have complex cell groups, monolayers, swirling, cohesion, and myoepithelial cells in epithelial sheets and the smear background. When NPBD (n = 53) and PBD (n = 33) were similarly compared, smears from PBD were more likely to exhibit larger and more complex cell groups, but they were otherwise similar to smears from NPBD.
CONCLUSIONS: There are many cytologic features that will allow a distinction of NPBD/PBD from PBDA/DCIS, but relatively few that can aid in separating NPBD from PBD.
METHODS: To allow for optimal cytohistologic correlation, 2 smears (1 hematoxylin and eosin-stained and 1 Diff-Quik-stained) were prepared from each of 98 breast biopsies without mass lesions and compared with the corresponding histologic sections of the scraped area. Each smear was reviewed in a blinded fashion and assessed for cellularity, background elements, cytoarchitectural features of cell groups, and nuclear features by 2 reviewers. Smears were then classified as nonproliferative breast disease (NPBD), proliferative breast disease without atypia (PBD) or with atypia (PBDA), or DCIS, based on review of the corresponding histologic sections.
RESULTS: When comparing NPBD/PBD (n = 86) with PBDA/DCIS (n = 12), smears from PBDA/DCIS were significantly (by the Fisher exact test or Wilcoxon rank sum P values with adjustment for multiple comparisons) more likely to be cellular; contain single cells and necrosis; exhibit nuclear overlap and cytoplasmic vacuoles; have large nuclei, macronucleoli, pleomorphism, clumped chromatin, and hyperchromasia; and were less likely to have complex cell groups, monolayers, swirling, cohesion, and myoepithelial cells in epithelial sheets and the smear background. When NPBD (n = 53) and PBD (n = 33) were similarly compared, smears from PBD were more likely to exhibit larger and more complex cell groups, but they were otherwise similar to smears from NPBD.
CONCLUSIONS: There are many cytologic features that will allow a distinction of NPBD/PBD from PBDA/DCIS, but relatively few that can aid in separating NPBD from PBD.