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Article: Atypical aspirates of the breast: A dilemma in current cytology practice

TitleAtypical aspirates of the breast: A dilemma in current cytology practice
Authors
Issue Date2017
Citation
Journal of Clinical Pathology, 2017, v. 70, n. 12, p. 1024-1032 How to Cite?
AbstractAims The probabilistic approach is widely adopted for breast fine needle aspiration cytology. However, a definite cytological diagnosis is not always possible for C3 (atypia) cases, which poses a management dilemma as this represents a mixed category of benign and malignant cases. It would be beneficial to be able to predict malignancy based on specific cytological features in C3 aspirates. Methods A comprehensive panel of cytological features (including quantitative, cytomorphological and background features) in a large cohort of C3 breast aspirates with subsequent histological excisions was evaluated to identify relevant morphological criteria predicting the risk of subsequent malignancy. Results A total of 229 C3 specimens with histological follow-up were included. Malignant outcome was found in 30.1% of specimens and the majority were invasive cancers. Features that showed a significant association with malignant outcome included older age (p=0.001), lower percentage of epithelial cell clusters and high percentage of single cells (p=0.002), cribriform architecture in cell clusters (p=0.034), presence of intracellular mucin (p=0.027), increased cell clusters without myoepithelial cells (p=0.048), diminished fibromyxoid stromal fragments (p=0.001), reduced bipolar nuclei (p=0.021) and the presence of necrosis (p=0.023). Except for the percentages of single cells and cell clusters without myoepithelial cells, all other features were shown to be independent risk predictors in multivariate analysis. Conclusions C3 aspirates were associated with a significant probability of histological malignancy. Certain quantitative, cytomorphological and background features were potentially helpful in predicting the risk of a malignant outcome. The prediction could be clinically useful in the management of C3 cases.
Persistent Identifierhttp://hdl.handle.net/10722/343486
ISSN
2023 Impact Factor: 2.5
2023 SCImago Journal Rankings: 0.934

 

DC FieldValueLanguage
dc.contributor.authorYu, Shuang Ni-
dc.contributor.authorLi, Joshua-
dc.contributor.authorWong, Sio In-
dc.contributor.authorTsang, Julia Y.S.-
dc.contributor.authorNi, Yun Bi-
dc.contributor.authorChen, Jie-
dc.contributor.authorTse, Gary M.-
dc.date.accessioned2024-05-10T09:08:30Z-
dc.date.available2024-05-10T09:08:30Z-
dc.date.issued2017-
dc.identifier.citationJournal of Clinical Pathology, 2017, v. 70, n. 12, p. 1024-1032-
dc.identifier.issn0021-9746-
dc.identifier.urihttp://hdl.handle.net/10722/343486-
dc.description.abstractAims The probabilistic approach is widely adopted for breast fine needle aspiration cytology. However, a definite cytological diagnosis is not always possible for C3 (atypia) cases, which poses a management dilemma as this represents a mixed category of benign and malignant cases. It would be beneficial to be able to predict malignancy based on specific cytological features in C3 aspirates. Methods A comprehensive panel of cytological features (including quantitative, cytomorphological and background features) in a large cohort of C3 breast aspirates with subsequent histological excisions was evaluated to identify relevant morphological criteria predicting the risk of subsequent malignancy. Results A total of 229 C3 specimens with histological follow-up were included. Malignant outcome was found in 30.1% of specimens and the majority were invasive cancers. Features that showed a significant association with malignant outcome included older age (p=0.001), lower percentage of epithelial cell clusters and high percentage of single cells (p=0.002), cribriform architecture in cell clusters (p=0.034), presence of intracellular mucin (p=0.027), increased cell clusters without myoepithelial cells (p=0.048), diminished fibromyxoid stromal fragments (p=0.001), reduced bipolar nuclei (p=0.021) and the presence of necrosis (p=0.023). Except for the percentages of single cells and cell clusters without myoepithelial cells, all other features were shown to be independent risk predictors in multivariate analysis. Conclusions C3 aspirates were associated with a significant probability of histological malignancy. Certain quantitative, cytomorphological and background features were potentially helpful in predicting the risk of a malignant outcome. The prediction could be clinically useful in the management of C3 cases.-
dc.languageeng-
dc.relation.ispartofJournal of Clinical Pathology-
dc.titleAtypical aspirates of the breast: A dilemma in current cytology practice-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1136/jclinpath-2016-204138-
dc.identifier.pmid28554890-
dc.identifier.scopuseid_2-s2.0-85027272495-
dc.identifier.volume70-
dc.identifier.issue12-
dc.identifier.spage1024-
dc.identifier.epage1032-
dc.identifier.eissn1472-4146-

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