PubMed · 14039767
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H TORRES MARTINEZ. [Functional mastopathies].. https://pubmed.ncbi.nlm.nih.gov/14039767/
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This study was undertaken to determine the discriminating cytological features between nonhigh-grade duct carcinoma in situ (NHGDCIS) and benign breast lesions and to determine any histological characteristics which would influence the cytological categorization. Smears of 12 each of histologically confirmed NHGDCIS and benign breast lesions were reviewed with regard to cellularity, cell discohesion, nuclear atypia, crowding of cells, tubule formation, necrosis, and presence of bare atypical nuclei and regular bare bipolar nuclei, and statistically analyzed. Architectural pattern, presence of necrosis, and the size of the lesion assessed at histological examination were compared with the initial cytological categorization. NHGDCIS lesions showed more cell discohesion (P = 0.04), bare atypical nuclei (P = 0.05), necrosis (P = 0.03), and sparse bare bipolar nuclei (P = 0.02) than benign lesions. These differences were statistically significant. Cellularity (P = 0.8), nuclear atypia (P = 0.06), crowding of cells (P = 0.1), and tubule formation did not show a significant difference. Six (out of six lesions) with a solid architectural pattern and six (of seven) with necrosis could be cytologically categorized as suspicious or malignant. Size of the lesion did not influence this. We conclude that cell discohesion, bare atypical and bare bipolar nuclei, and necrosis are discriminating features between NHGDCIS and benign breast lesions and NHGDCIS lesions with a solid architectural pattern and necrosis are more likely to be satisfactorily categorized cytologically.
OBJECTIVE: The investigation of the value of sonographic criteria for the assessment of the character of solid breast lesions. METHODS: 281 preoperative sonographic studies of breast lesions were analysed and classified according to the following features: characteristics of the contour, echodensity, echo pattern, posterior acoustic properties, mobility, compressibility, axis of the lesion, L/T ratio (longitudinal size divided by transverse size), and architecture of surrounding tissue. We assessed the differential diagnostic value of each feature based on frequency distribution and odds ratio (OR). RESULTS: 152 (54.1 %) benign and 129 (45.9 %) malignant breast lesions were evaluated by ultrasound. The following sonographic criteria were the most clear-cut signs for lesions to be malignant: ill-defined borders (OR: 19.8), incompressibility (OR: 9.7), and discontinuity of Cooper's ligaments (OR: 4.8). Benign lesions were characterised by compressibility (OR: 0.12), smooth borders (OR: 0.12), and displacement of Cooper's ligaments (OR: 0.24). CONCLUSION: When distinguishing benign from malignant breast lesions, ultrasound examiners should be primarily guided by the lesion's contour and compressibility and the architecture of the surrounding tissue. Aiming for the widest possible consensus on terminology issues and standardised interpretation of the above criteria would help to advance breast sonography from its current status as a supplementary technique to the status of the modality of choice for the early diagnosis of breast cancer.
Breast cancer usually develops after a series of epithelial changes in the terminal ductolobular unit. There are multiple benign causes of breast lumps, the majority of which are not associated with an increased risk of breast cancer. Histological changes of pre-malignancy such as atypical hyperplasia and in situ carcinoma can be identified, and these are indications for either close surveillance or further surgery. At the time of diagnosis, breast cancers can be staged both clinically and pathologically, and this facilitates international comparisons of results of treatment.