This study aims to retrospectively analyze over 75 cases from the past 6 years to evaluate the utility and accuracy of fine needle aspiration cytology in diagnosing papillary lesions of the breast. The study will examine cytological features, correlate findings with histopathology, and calculate sensitivity, specificity, and predictive values. The results will help determine the challenges in diagnosing this heterogeneous group of breast lesions on FNAC and improve diagnostic accuracy.
This study aims to retrospectively analyze over 75 cases from the past 6 years to evaluate the utility and accuracy of fine needle aspiration cytology in diagnosing papillary lesions of the breast. The study will examine cytological features, correlate findings with histopathology, and calculate sensitivity, specificity, and predictive values. The results will help determine the challenges in diagnosing this heterogeneous group of breast lesions on FNAC and improve diagnostic accuracy.
This study aims to retrospectively analyze over 75 cases from the past 6 years to evaluate the utility and accuracy of fine needle aspiration cytology in diagnosing papillary lesions of the breast. The study will examine cytological features, correlate findings with histopathology, and calculate sensitivity, specificity, and predictive values. The results will help determine the challenges in diagnosing this heterogeneous group of breast lesions on FNAC and improve diagnostic accuracy.
This study aims to retrospectively analyze over 75 cases from the past 6 years to evaluate the utility and accuracy of fine needle aspiration cytology in diagnosing papillary lesions of the breast. The study will examine cytological features, correlate findings with histopathology, and calculate sensitivity, specificity, and predictive values. The results will help determine the challenges in diagnosing this heterogeneous group of breast lesions on FNAC and improve diagnostic accuracy.
TITLE-fine needle aspiration cytology of papillary lesion of breast 6 year retrospective study.
INSTITUTE DEPARTMENT OF PATHOLOGY, SETH G.S.MEDICAL COLLEGE AND KEM HOSPITAL, MUMBAI. INVESTIGATORS POST-GRADUATE GUIDE (PRINCIPAL INVESTIGATOR) DR. LEENA NAIK (PROFESSOR) DEPARTMENT OF PATHOLOGY SETH G.S. MEDICAL COLLEGE AND KEM HOSPITAL, MUMBAI. POST-GRADUATE STUDENT (CO-INVESTIGATOR) DR.GARIMA VIJAYVERGIYA(RESIDENT) DR.KANCHAN KOTHARI (ASSOCIATE PROFESSOR) DEPARTMENT OF PATHOLOGY SETH G.S. MEDICAL COLLEGE AND KEM HOSPITAL, MUMBAI.
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INDEX TOPIC
PAGE NO.
Introduction
Aims and Objectives
Materials and Methods
2-3
References
ATTACHMENTS 1 .Summary of protocol 2.Case record form
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INTRODUCTION :Papillary lesions of the breast are a heterogeneous group of breast
lesions. Cytological interpretation of papillary lesions of breast is a difficult task. These lesions have risk of false-positive diagnosis .These lesions have varied morphologic features that carry different prognosis. Accurate diagnosis is required to ensure that effective treatment is achieved. These lesions present clinically as a mass or nipple discharge without a clinically evident lump. Papillary lesions of the breast include:1. papillary hyperplasia in fibrocystic disease 2. benign papilloma 3.malignant papillary lesions including
micropapillary, intracystic and invasive papillary
carcinoma. Papillomas of the breast can be divided into solitary papillomas, multiple papillomas, and juvenile papillomatosis Papillary carcinoma is rare, constituting 12% of breast cancer. it can be noninvasive or invasive papillary carcinoma and invasive micropapillary carcinoma.. The noninvasive form may extend throughout a ductal system (intraductal) or may be confined within a cystic structure (intracystic). Rationale-. papillary lesions of breast are wide spectrum of disease. It includes benign as
well as malignant papillary lesions. It is difficult to differentiate between benign and
malignant papillary lesions as it has overlapping cytomorphological features. sometimes degenerative changes also mimic malignancy . We are carrying out this study, to find out difficulties faced in diagnosis of papillary lesions of breast, so as to improve dianostic accuracy.
Parameters that will be used to determine utility of FNAC for diagnosing papillary lesions of breast:1.background-Blood,calcification,single macrophages ,myoepithelial cells.
scattered
columnar
cells,
hemosiderin
laden
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2.Cellular features-Cellularity, dissociation,
nuclear atypia, nuclear pseudoinclusions, cell
morphology,e.g.,apocrine,columnar 3.Tissue fragments-Long finger-like branching fragment(complex vs.simple branching,presense of fibrovascular cores),complex fragments,other than papillary,cellular balls,single detached papillae,tiny tongue like projections.
AIMS AND OBJECTIVES
This will be a 6 year retrospective study dealing with: 1) Utility of Fine Needle Aspiration Cytology (FNAC) in diagnosis of papillary lesions of breast 2) To determine the cytomorphological spectrum of the papillary lesion of breast FNAC 3) To correlate Fine Needle Aspiration Cytology finding of cases diagnosed as papillary lesion of breast with histopathology 4) To determine diagnostic accuracy of the FNAC in the diagnosis of papillary lesion 5) To find incidence of false positive and false negative cases
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MATERIALS AND METHODS
This will be a 6 year retrospective study
Inclusion criteria-all the case which have been diagnosed as papillary lesion on FNAC and also all the lesions which are diagnosed as papillary lesions of breast on histopathology, which have not been diagnosed as papillary lesion on FNAC.So false negative test would not be missed.
Exclusion criteria-Lesions diagnosed as non papillary lesions on both FNAC and
histopathology.
Clinical history & notes of 75 patients will be obtained from the databases of cytology section in Department of Pathology, Medical record department and surgical histopathology section.
The FNAC slides obtained by aspiration and non aspiration technique, stained with Giemsa and PAP stain will be retrieved and studied.
The cases will be analysed based on the cytological features and correlated with histopathological records.
Sensitivity, specificity, positive and negative predictive value will be calculated.
Statistical analysis will be performed by using software programme available for the same known as SPSS (Statistical Package for Social Sciences).
Where the False negative cases - which are diagnosed non papillary on FNAC and diagnosed as papillary on histopath.
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False positive cases - which are diagnosed as papillary on FNAC and non papillary on histopathology. False negative test for malignancy- when in FNAC lesion diagnosed as benign and on histopathology diagnosed as malignant. False positive test for malignancy-when in FNAC lesion diagnosed as malignant and on histopathology diagnosed as benign.
OBSERVATION: Cytological findings will be correlated with Histopathological records. Incidence of various lesions will be studied. All the cases 1.
cases diagnosed as papillary lesions on FNAC will be on histopathology follow up.
2.
Cases diagnosed as nonpapillary on FNAC but diagnosed as papillary on histopath
examination.
3.
All the cases which were diagnosed as papillary lesion on FNAC, but revealed as non-papillary on further histopathological examinations will be studied in detail.
Slides will be retrived and various variant of papillary lesion will be studied. Sensitivity, specificity, positive and negative predictive value will be calculated. Statistical analysis will be performed by using software programme available for the same known as SPSS (Statistical Package for Social Sciences).
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REFERENCES 1.D Prathiba, Shalinee Rao, [...], and Leena Dennis Joseph Papillary lesions of breast An introspect of cytomorphological features Jcytol jan 2010,27(1) :12-15 2.Nayar R, De Frias DV, Bourtsos EP, Sutton V, Bedrossian C. Cytological differential diagnosis of papillary pattern in breast aspirates: Correlation with histology. Ann Diagn Pathol. 2001;5:34 42. [PubMed] 3.Tse GM, Ma TK, Lui PC, Ng DC, Yu AM, Vong JS, et al. Fine needle aspiration cytology of papillary lesions of the breast: How accurate is the diagnosis? J Clin Pathol. 2008;61:9459. [PubMed 4.Reid-Nicholson MD, Tong G, Cangiarella JF, Moreira AL. Cytomorphologic features of papillary lesions of the male breast: a study of 11 cases. Cancer. 2006;108:222230 5.Jeffrey PB, Ljung BM. Benign and malignant papillary lesions of the breast. A cytomorphological study.Am J ClinPathol.1994;101:500-507 6.Michael CW, Buschmann B. Can true papillary neoplasms of breast and their mimickers be accurately classified by cytology?Cancer (Cancer Cytopathol).2002;96:92100
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SUMMARY Papillary lesion of breast encompass wide spectrum of lesions both benign and malignant. It constitutes 1-2% of cases. These lesions have varied clinical, radiological features which causes diagnostic difficulties. This retrospective study of 6 years, will highlight the spectrum of cytomorphological findings of papillary lesion of breast. Clinical, and histopathological correlation will help to assess sensitivity, specificity, accuracy, positive and negative predictive value of FNAC in diagnosing papillary lesion of breast.
Comparative Evaluation of Robinson'S Cytological Grading With Elston and Ellis' Nottingham Modification of Bloom Richardson Histopathology Grading For Breast Carcinoma
Comparative Evaluation of Robinson'S Cytological Grading With Elston and Ellis' Nottingham Modification of Bloom Richardson Histopathology Grading For Breast Carcinoma
