[336] Atypia in Papillary Lesions of Breast in Fine Needle Aspiration Biopsy and Association with Malignancy

Rashmi Batra, Rajesh Singla, Hillary Pearson, Jean Marc Cohen, Manju Harshan. Beth Israel Medical Center, New York, NY

Background: Fine needle aspiration biopsy(FNAB) is a frequiently used method for diagnosing papillary lesions of the breast. The challenge is in differentiating papillomas from benign non papillary proliferations and to distinguish benign papillomas from malignancy which includes papillary and non papillary types.
Design: The pathology database of Beth Israel medical center was searched for women who under went excisional biopsy after an initial diagnosis of papillary lesion(PL) on FNAB. 130 cases were identified. The biopsies were done with and with out ultrasouind guidance.Ages ranged from 20 to 92. The findings were categorised on the basis of presence or absence of atypia on FNAB and the final diagnosis.
Results are shown in the tables.

Diagnosis on excisonal biopsyPL with atypia on FNAB n (%)PL without atypia on FNAB n (%)
Carcinoma( IDCA, DCIS, Papillary) n=2812 (9.2%)16 (12.3%)
LCIS n=73 (2.3%)4 (3%)
Papilloma with atypia n=64 (3%)2 (1.5%)
Papilloma n=638 (6.1%)55 (42.3%)
FCC/FA/BPT n=250 (0%)25 (19.2%)
Adenomyoepithelioma n=10 (0%)1 (0.7%)
IDCA- Invasive duct carcinoma, DCIS- Ductal carcinoma insitu, LCIS- Lobular carcinoma insitu, FCC- fibrocystic change, FA- fibroadenoma, BPT- Benign phyllodes tumor

Conclusions: Absence of atypia in FNAB did not exclude malignancy.
Presence of atypia in FNAB had a high incidence of carcinoma on excisional biopsy.
Presence of atypia was not always associated with malignancy.
High incidence of carcinoma warrants surgical excision of papillary lesions for further evaluation.
Category: Cytopathology

Tuesday, March 20, 2012 9:30 AM

Poster Session III # 85, Tuesday Morning


Close Window