title: Cell blocks of breast FNAs frequently allow diagnosis of invasion or histological classification of proliferative changes.
abstract: Two major limitations of breast fine needle aspiration (FNA) compared with core needle biopsies (CNB) are the inability to determine whether a cancer is invasive and to classify proliferative lesions. We studied 40 consecutive "rapid cell blocks" from breast FNAs with surgical pathology follow-up to test whether cell blocks can overcome these limitations. Of 25 carcinomas, invasion could be identified in the cell block sections in 11 (44%). One cystosarcoma phyllodes was suspected based on the cell block sections. Cell blocks from 12 of 14 benign breast FNAs showed sufficient cells to assign a histologic diagnosis of no hyperplasia (1 case, confirmed on follow-up) and usual hyperplasia (11 cases; confirmed in eight of 11 on follow-up). Specific histologic diagnoses included intraductal papilloma (2 cases), and in situ lobular neoplasia (2 cases). Cell blocks complement smears and monolayers and appear to overcome major limitations of breast FNA.
authors.affiliation: Department of Pathology, Umass Memorial Health Center, Worcester, MA 01605, USA.
authors.forename: Smiljana
authors.initials: S
authors.lastname: Istvanic
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Fischer
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Banner
authors.forename: Donna M
authors.initials: DM
authors.lastname: Eaton
authors.forename: Anne C
authors.initials: AC
authors.lastname: Larkin
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khan
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology; D044963:Biopsy, Fine-Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000145:classification / Q000473:pathology*; D002278:Carcinoma in Situ / Q000145:classification / Q000473:pathology; D018275:Carcinoma, Lobular / Q000145:classification / Q000473:pathology; D049109:Cell Proliferation; D005260:Female; D006801:Humans; D006965:Hyperplasia; D009361:Neoplasm Invasiveness; D018299:Neoplasms, Ductal, Lobular, and Medullary / Q000145:classification / Q000473:pathology*; D018300:Papilloma, Intraductal / Q000145:classification / Q000473:pathology; D016612:Paraffin Embedding / Q000379:methods*; D003557:Phyllodes Tumor / Q000145:classification / Q000473:pathology