False negative cytologic diagnosis of breast carcinoma.
OBJECTIVE
To study the reasons for interpretive errors in false negative diagnosis of breast carcinoma on fine needle aspiration cytology material.


METHODS
We reviewed only those histologically proved malignant cases where the cytologic material was abnormal and to some extent misinterpreted.


RESULTS
There were four lobular carcinomas and one each case of in situ, infiltrating duct, medullary and tubular carcinoma. Smears of lobular carcinomas were hypocellular overall, and the cells showed minimal nuclear pleomorphism. In situ, medullary and tubular carcinoma were associated with fibrocystic changes. The presence of bipolar cells and stromal fragments was misleading in cases of infiltrating duct carcinoma.


CONCLUSIONS
The presence of associated fibrocystic disease may be a misleading factor since it may mask a malignancy. Hypocellularity and relatively nuclear monomorphism were the most common reasons for failure to diagnose malignant breast lesions. Careful attention should be paid to extreme nuclear monomorphism and absence of naked bipolar cells. A cytologically atypical or suspicious diagnosis together with radiologic suspicion should suggest a diagnosis of malignancy.
Dey
P
P
Cytology Unit, Mubarak Al Kabeer Hospital, Kuwait. medinst@pgi.chd.nic.in
Luthra
U K
UK
D000230:Adenocarcinoma / Q000473:pathology; D000328:Adult; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000145:classification / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D018276:Carcinoma, Medullary / Q000473:pathology; D005188:False Negative Reactions; D005260:Female; D005348:Fibrocystic Breast Disease / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D012189:Retrospective Studies