Objective: To put forth the cytological features and diagnostic pitfalls of spontaneously infarcted breast lesions on fine-needle aspiration cytology (FNAC). Study Design: We present 19 cases of spontaneously infarcted breast lesions encountered on FNAC over a 5-year period. Histological follow-up was correlated wherever available. Results: The majority of cases were seen in the second decade of life. The smears in all 19 cases were cellular. The cytomorphologic findings were scattered dyscohesive cells (n = 16), ghost cells (n = 11) and necrosis (n = 10). The dyscohesive cells were small and had a normal nuclear cytoplasmic ratio with pyknotic nuclei. The presence of viable epithelial cells or stromal fragments helped in the diagnosis of the primary breast lesion and was seen in all 19 cases. Cytology diagnoses were infarcted fibroadenoma (n = 11), infarcted breast lesion (n = 3), Phyllodes tumor (n = 2), papillary lesion (n = 2) and infarcted benign breast lesion (n = 1). Histopathology was available in 13 cases, 12 were concordant and 1 was inadequate for primary diagnosis. Conclusion: An infarcted breast lesion poses diagnostic difficulties on cytology. It needs to be differentiated from inflammatory lesions and malignancy. A cytopathologist should be aware of the entity and recognize its cytomorphologic features.

Keywords:
Fine-needle aspiration cytology, Breast lesions, Spontaneous infarction, Diagnostic pitfalls
1.
Ishihara A, Kobayashi TK: Infarcted intraductal papilloma of the breast: cytologic features with stage of infarction. Diagn Cytopathol 2006;34:373-376.
2.
McCutcheon JM, Lipa M: Infarction of a fibroadenoma following fine needle aspiration. Cytopathology 1993;4:247-250.
3.
Lucey JJ: Spontaneous infarction of the breast. J Clin Pathol 1975;28:937-943.
4.
Kavdia R, Kini U: WCAFTI: Worrisome cytologic alterations following tissue infarction; a mimicker of malignancy in breast cytology. Diagn Cytopathol 2008;36:586-588.
5.
Deshpande KM, Deshpande AH, Raut WK, Lele VR, Bobhate SK: Diagnostic difficulties in spontaneous infarction of a fibroadenoma in an adolescent: case report. Diagn Cytopathol 2002;26:26-28.
6.
Ferrer PL, Peramata PG, Hefferman JAJ, Vicandi B, Viguer JM: Spontaneous infarction in fibroadenoma. Diagn Cytopathol 2002;28:104-105.
7.
Newman J, Kahn LB: Infarction of fibroadenoma of the breast. Br J Surg 1973;60:738-740.
8.
Greenberg ML, Middleton PD, Bilous AM: Infarcted intraductal papilloma diagnosed by fine-needle biopsy: a cytologic, clinical, and mammographic pitfall. Diagn Cytopathol 1994;11:188-191.
9.
Kobayashi TK, Ueda M, Nishino T, Watanabe S, Yakushiji M: Spontaneous infarction of an intraductal papilloma of the breast: cytological presentation on fine-needle aspiration. Cytopathology 1992;3:379-384.
10.
Wilkinson L, Green WO: Infarction of breast lesions during pregnancy and lactation. Cancer 1964;17:1567-1572.
11.
Pambakian H, Tighe JR: Mammary infarction. Br J Surg 1971;58:601-602.
12.
Nudelman HL, Kempson RL: Necrosis of the breast: a rare complication of anticoagulant therapy. Am J Surg 1966;111:728-733.
13.
Ichihara S, Matsuyama T, Kubo K, Tamura Z, Aoyama H: Infarction of breast fibroadenoma in a postmenopausal woman. Pathol Int 1994;44:398-400.
14.
Cangiarella J, Simsir A: Breast; in Orell SR, Sterrett GF (eds): Orell and Sterrett's Fine Needle Aspiration Cytology, ed 5. Edinburgh, Churchill Livingstone, 2012, pp 167-168.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.