Objective: To identify associations between cytological criteria in fine needle aspiration (FNA) specimens and histological subtypes of lobular breast carcinoma (classical and other types). Study Design: FNA cytology and mastectomy specimens from 72 cases of invasive lobular breast carcinoma were consecutively retrieved from the files of the Amaral de Carvalho Hospital, Jaú-São Paulo, Brazil. All cases were reviewed regarding five cytological criteria: cellularity, cellular cohesion, presence of inflammation, nucleoli and nuclear atypia. The χ2 test or Fisher's exact tests with 95% confidence intervals (CI) were used. Results: The classical type showed lower initial cytological diagnosis of malignancy compared to the other variants (p = 0.017; odds ratio (OR) 0.26, 95% CI 0.89-0.80). Moderate/intense cellular cohesion (p = 0.011; OR 0.18, 95% CI 0.04-0.73) and mild atypia (p = 0.000; OR 16.15, 95% CI 3.20-81.48) were significantly associated with the classical type of lobular breast carcinoma, while the absence of inflammation (p = 0.082; OR 0.36, 95% CI 0.12-1.15) was marginally associated with the classical type. Conclusions: In cytology, the characterization of lobular carcinoma as malignant is difficult, especially the classical type. The association between cell cohesion and the classical type of lobular breast carcinoma may be one of the factors that complicate this diagnosis.

1.
Koss LG: The palpable breast nodule: a cost-effectiveness analysis of alternate diagnostic approaches. The role of the needle aspiration biopsy. Cancer 1993;72:1499-1502.
2.
Collaço LM, de Lima RS, Werner B, Torres LF: Value of fine needle aspiration in the diagnosis of breast lesions. Acta Cytol 1999;43:587-592.
3.
Young NA, Mody DR, Davey DD: Diagnosis and subclassification of breast carcinoma by fine-needle aspiration biopsy: results of the interlaboratory comparison program in non-gynecologic cytopathology. Arch Pathol Lab Med 2002;126:1453-1457.
4.
Choi YD, Choi YH, Lee JH, Nam JH, Juhng SW, Choi C: Analysis of fine needle aspiration cytology of the breast: a review of 1,297 cases and correlation with histologic diagnoses. Acta Cytol 2004;48:801-806.
5.
Dabbs DJ: Prognostic information from fine-needle aspiration biopsy of breast carcinoma. Am J Clin Pathol 2000;113:S76-S83.
6.
Chaiwun B, Sukhamwang N, Lekawanvijit S, Sukapan K, Rangdaeng S, Muttarak M, et al: Atypical and suspicious categories in fine needle aspiration cytology of the breast: histological and mammographical correlation and clinical significance. Singapore Med J 2005;46:706-709.
7.
Saravanja S, Kubik-Huch RA, Komminoth P, Jöstingmeier S, Hohl M, Otto RC: Ultrasound-guided fine-needle aspiration of the breast. Praxis 2005;94:673-679.
8.
Chaiwun B, Thorner P: Fine needle aspiration for evaluation of breast masses. Curr Opin Obstet Gynecol 2007;19:48-55.
9.
Medina-Franco H, Abarca-Pérez L, Cortés-González R, Soto-Germes S, Ulloa JA, Uribe N: Fine needle aspiration biopsy of breast lesions: institutional experience (in Spanish). Rev Invest Clin 2005;57:394-398.
10.
Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, Thun MJ, American Cancer Society: Cancer statistics, 2004. CA Cancer J Clin 2004;54:8-29.
11.
Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, van de Vijver MJE: WHO Classification of Tumours of the Breast. Lyon, World Health Organization, 2012, pp 39-42.
12.
Tan SM, Behranwala KA, Trott PA, Nasiri NA, Moskovic E, Brown G, et al: A retrospective study comparing the individual modalities of triple assessment in the pre-operative diagnosis of invasive lobular breast carcinoma. Eur J Surg Oncol 2002;28:203-208.
13.
Leach C, Howell LP: Cytodiagnosis of classic lobular carcinoma and its variants. Acta Cytol 1992;36:199-202.
14.
Auger M, Huttner I: Fine-needle aspiration cytology of pleomorphic lobular carcinoma of the breast. Comparison with the classic type. Cancer 1997;81:29-32.
15.
Jayaram G, Swain M, Chew MT, Yip CH: Cytologic appearances in invasive lobular carcinoma of the breast. A study of 21 cases. Acta Cytol 2000;44:169-174.
16.
Hwang S, Ioffe O, Lee I, Waisman J, Cangiarella J, Simsir A: Cytologic diagnosis of invasive lobular carcinoma: factors associated with negative and equivocal diagnoses. Diagn Cytopathol 2004;31:87-93.
17.
Anshu, Herbert A, Cochand-Priollet B, Cross P, Desai M, Dina R, et al: Survey of medical training in cytopathology carried out by the journal Cytopathology. Cytopathology 2010;21:147-156.
18.
Arisio R, Cuccorese C, Accinelli G, Mano M-P, Bordon R, Fessia L: Role of fine-needle aspiration biopsy in breast lesions: analysis of a series of 4,110 cases. Diagn Cytopathol 1998;18:462-467.
19.
Shabb NS, Boulos FI, Abdul-Karim FW: Indeterminate and erroneous fine-needle aspirates of breast with focus on the ‘true gray zone': a review. Acta Cytol 2013;57:316-331.
20.
The uniform approach to breast fine-needle aspiration biopsy. NIH Consensus Development Conference. Am J Surg 1997;174:371-385.
21.
Tse GM, Tan PH, Schmitt F: Fine Needle Aspiration Cytology of the Breast: Atlas of Cyto-Histologic Correlates. Heidelberg, Springer, 2013.
22.
Bofin AM, Lydersen S, Hagmar BM: Cytological criteria for the diagnosis of intraductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma of the breast. Diagn Cytopathol 2004;31:207-215.
23.
Bonzanini M, Gilioli E, Brancato B, Cristofori A, Bricolo D, Natale N, Valentini A, Dalla Palma P: The cytopathology of ductal carcinoma in situ of the breast. A detailed analysis of fine needle aspiration cytology of 58 cases compared with 101 invasive ductal carcinomas. Cytopathology 2001;12:107-119.
24.
Dabbs DJ, Schnitt SJ, Geyer FC, Weigelt B, Baehner FL, Decker T, et al: Lobular neoplasia of the breast revisited with emphasis on the role of E-cadherin immunohistochemistry. Am J Surg Pathol 2013;37:1-11.
25.
Menet E, Becette V, Briffod M: Cytologic diagnosis of lobular carcinoma of the breast: experience with 555 patients in the Rene Huguenin Cancer Center. Cancer 2008;114:111-117.
26.
Manfrin E, Falsirollo F, Remo A, Reghellin D, Mariotto R, Dalfior D, et al: Cancer size, histotype, and cellular grade may limit the success of fine-needle aspiration cytology for screen-detected breast carcinoma. Cancer 2009;23:491-499.
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.