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Cytologic diagnosis of lobular carcinoma of the breast
Author(s) -
Menet Emmanuelle,
Becette Véronique,
Briffod Marianne
Publication year - 2008
Publication title -
cancer cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23347
Subject(s) - medicine , lobular carcinoma , malignancy , invasive lobular carcinoma , carcinoma , breast carcinoma , breast cancer , radiology , cancer , cytopathology , cytology , pathology , fine needle aspiration , ductal carcinoma , biopsy , invasive ductal carcinoma
BACKGROUND Fine‐needle aspiration generally produces results that are not as good for lobular carcinoma as the results for ductal carcinoma of the breast. In this study, the authors evaluated their team's performance in cytologic diagnosis of lobular carcinoma over 11 years and analyzed the reasons for diagnostic failure. METHODS Cytologic findings were analyzed in 555 consecutive fine‐needle cytopuncture specimens from women with palpable, invasive lobular carcinoma of the breast. The authors also examined the influence of the cytologist's experience, the clinical tumor size, the histologic subtype, and the histologic grade on diagnostic performance. All negative samples were re‐examined, along with all samples that had been obtained during the last year of the study, to refine the morphologic description of lobular carcinoma. RESULTS Malignancy was diagnosed in 68.8% of specimens overall. The individual pathologists diagnosed malignancy in from 44.4% to 81.1% of specimens, depending on their experience. Diagnostic performance was correlated with clinical tumor size, histologic grade, and histologic subtype, and correct diagnoses were significantly more frequent in pleomorphic subtypes than in “classic” types. Re‐examination of all 32 negative specimens reduced the false‐negative rate from 5.8% to 3.8%. CONCLUSIONS Despite the pitfalls associated with lobular carcinoma of the breast, fine‐needle cytopuncture remains a useful diagnostic tool before treatment. Failures can be reduced through experience and by better knowledge of cytologic features. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society.