title: Papillary breast lesions diagnosed on cytology. Profile of 65 cases.
abstract: OBJECTIVE
  To analyze the cytologic features of nipple discharge and fine needle aspiration (FNA) cytologic smears from breast lesions reported as showing papillary features and to correlate them with histopathologic features.
  
  
  METHODS
  The study group consisted of FNA smears and/or nipple discharge smears from 65 breast lesions diagnosed on cytology as duct papilloma, papillary lesion, fibrocystic condition, fibroadenoma, papillary neoplasm or papillary carcinoma. Cytomorphologic features assessed included cellularity, cell pattern (clusters, papillary, 3-dimensionality, etc.) and cell characteristics (monomorphism, pleomorphism, apocrine change, plasmacytoid features). Histological material was available for review and cytohistologic correlation in all cases.
  
  
  RESULTS
  Forty-six specimens were FNA smears, and 16 were nipple discharge smears; in 3 cases FNA and nipple discharge cytologic smears were available for review. Cytologic study could predict the presence of a papillary pattern in all neoplasms with pure or focal papillary differentiation. There was an overlap in cytomorphologic features between papillary and nonpapillary benign lesions as well as between benign and malignant papillary neoplasms. Frank blood in the aspirate, cell dissociation and atypia, however, were more frequent in the last.
  
  
  CONCLUSIONS
  Overlap of cytologic features in nonneoplastic and neoplastic benign papillary lesions and between benign and malignant papillary neoplasms necessitates histologic evaluation in all cases diagnosed as papillary on cytology. Since 49.2% of lesions showing papillary features on cytology prove to be malignant, all cases reported as papillary on cytology should be excised urgently for histologic assessment.
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. gitajayaram@yahoo.com
authors.forename: Gita
authors.initials: G
authors.lastname: Jayaram
authors.forename: Elnazir Mohamed
authors.initials: EM
authors.lastname: Elsayed
authors.forename: Roshidah Binti
authors.initials: RB
authors.lastname: Yaccob
mesh_terms: D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D018226:Fibroadenoma / Q000473:pathology; D005348:Fibrocystic Breast Disease / Q000473:pathology; D006801:Humans; D018300:Papilloma, Intraductal / Q000473:pathology; D012680:Sensitivity and Specificity