A 17-year-old female underwent Fine Needle Aspiration cytology (FNAC) for a lump in the breast which was non-tender, firm and mobile. Which of the following features would suggest finding of a benign breast disease?(AIIMS November 2014, May 2013)
Ans. b. Tightly arranged ductal epithelial cells with dyseohesive bare nuclei (Ref: Winfred Grays diagnostic cytopathology 2/e p279-280)Non-tender, firm and mobile breast lump in a female of age 17 years is suggestive of fibroadenoma, in which tightly- arranged ductal epithelial cells with dyscohesive bare nuclei are seen on FNAC. (AIIMS May 2013 repeat)Fibroadenoma:Diagnostic findings on needle biopsy consist of:Abundant stromal cells which appear as bare bipolar nucleiSheets of fairly uniform-size epithelial cells that are typically arranged in either an antler like pattern or a honeycomb pattern.Foam cells and apocrine cells may also be seen, although these are less diagnostic features.FibroadenomaMC benign tumor of female breastQMC age group: 15-30 yearsQKnown as breast mouseQEtiology: Increased sensitivity of focal areas of breast tissue to estrogenQPathology:Encapsulated spherical lesion, composed of fibrous and glandular tissueQArise from interlobular stroma, stromal cells can be monoclonal or polyclonalTypes of FibroadenomaPericanalicularIntracanalicular* Hard* Due to proliferation of connective tissue inside the elastic lamina* Soft* Due to proliferation of connective tissue outside the elastic laminaClinical Features:Painless, slowly growing solitary mobile lump in the breast (Breast mouse)QDiagnosis:Characteristic popcorn calcificationQ on mammographyIOC is FNACQDiagnostic findings on needle biopsy consist ofAbundant stromal cells which appear as bare bipolar nucleiSheets of fairly uniform-size epithelial cells that are typically arranged in either an antler like pattern or a honeycomb pattern.Foam cells and apocrine cells may also be seen, although these are less diagnostic features.Treatment:No treatmentQ is necessary when diagnosis is confirmed.Excision biopsy is the treatment of choice for suspicious lesionQ and for cosmetic indications.
Dyscohesive ductal epithelial cells without cellular fragments
Tightly arranged ductal epithelial cells with dyscohesive bare nuclei
Stromal predominance with spindle cells
Polymorphism with single or arranged ductal epithelial cells
Breast