Fine needle aspiration cytological criteria for predicting solid papillary intraduct carcinoma of the breast

Abstract

The diagnosis of low and intermediate grade cribriform and papillary intraduct carcinoma including solid papillary intraduct carcinoma on fine needle biopsy (FNB) is controversial. Hence solid papillary intraduct carcinomas are often overcalled as invasive carcinoma or designated as ‘papillary lesions’ along with benign intraduct papillomas and invasive papillary carcinomas. The anatomical pathology department at St Vincent’s Hospital extracted all breast FNB cases from its database over a 6 year period which had been reported as suggestive of intraduct carcinoma on fine needle biopsy and had surgical follow up. The cases of solid papillary intraduct carcinoma were analysed using a worksheet of cytological diagnostic criteria for low and intermediate grade intraduct carcinoma. This worksheet was designed based on criteria extracted from the literature in combination with diagnostic criteria used at St Vincent’s Hospital. Cytological criteria predictive for solid papillary intraduct carcinoma were analysed and will be discussed. These criteria include ‘glomeruloid’ capillary loops, high cellularity, moderate nuclear atypia and marked single cell dispersal.