Breast cytology

Catania S, Ciatto S (1992) Breast cytology in clinical practice. Martin Dunitz, London... 

Gong Y, Symmans WF, Krishnamurthy S, et al. Optimal fixation conditions for immunocytochemical analysis of estrogen receptor in cytologic specimens of breast carcinoma. Cancer (Cancer Cytopathol.) 2004 102 34-40. 

Fetsch PA, Abati A. The effects of antibody clone and pretreatment method on the results of HER2 immunostaining in cytologic samples of metastatic breast cancer a query and a review of the literature. Diagn. Cytopathol. 2007 35 319-328. 

Ozello, L., DeRosa, C., Habif, D. V., and Greene, G. L. (1991) An immunohis-tochemical evaluation of progesterone receptor in frozen sections, paraffin sections, and cytologic imprints of breast carcinomas. Cancer 67,455 62. 

DCIS now forms some 20% of all breast cancers diagnosed by screening. Approximately 80% of DCIS is picked up due to microcalcifications (see later in chapter). Once the radiologist has identified suspicious calcifications, these are biopsied, so that architectural and cytological information can be obtained. 

Mendrinos S, Nolen JD, Styblo T, Carlson G, Pohl J, Lewis M, et al. Cytologic findings and protein expression profiles associated with ductal carcinoma of the breast in ductal lavage specimens using surface-enhanced laser desorption and ionization-time of flight mass spectrometry. Cancer 2005 105(3) 178—183. 

Itoh H, Miyajima Y, Umemura S, Osamura RY (2008). Lower HER-2/Chromosome Enumeration Probe 17 Ratio in Cytologic HER-2 Fluorescence in Situ Hybridization for Breast Cancers. Three-dimensional Analysis of Intranuclear Localization of Centromere 17 and HER-2 Signals. Cancer (Cancer Cytopathol) 114 134-40. 

Breast cancer is the most common cancer affecting women in Western societies. In the past decade, the incidence has risen by 25% and the lifetime risk (from 0 to 74 years) for white women developing breast cancer is around 7-8%.77 A combination of physical examination, mammography and fine needle aspiration cytology or needle core biopsy (triple assessment) is currently the most sensitive method for preoperative diagnosis of clinically and radiographically detected breast lesions. 

Secondary prevention occurs when a disease is detected early when the individual is asymptomatic. Medical screening is the periodic examination of an individual in order to detect preclinical disease. Examples of medical screening include use of urinary cytology in workers exposed to bladder carcinogens and mammography for asymptomatic cancer of the breast. 

The initial visit of a perimenopausal or postmenopausal woman is the most appropriate time to obtain a complete medical history, perform a physical examination, and educate the patient. Medical history should include determination of a personal or family history of thrombotic problems. The physical examination should include a complete cardiovascular examination, clinical assessment of thyroid status, and breast and pelvic examinations. Papanicolaou cervical cytologic examination and screening mammography negative for malignancy are required before initiating hormone therapy. Thyroid function tests and lipoprotein lipid profile also should be performed at the discretion of the clinician. 

Ciampa A, Fanger G, Khan A, et al. Mammaglobin and CRxA-01 in pleural effusion cytology potential utility of distinguishing metastatic breast carcinomas from other cytokeratin 7-positive/ cytokeratin 20-negative carcinomas. Cancer. 2004 102 368-372. 

Eiel MI, Cernaianu G, Burstein DE, et al. Value of GCDEP-15 (BRST-2) as a specific immunocytochemical marker for breast carcinoma in cytologic specimens. Acta Cytol. 1996 40 637-641. 

Keshgegian AA, Inverse K, Kline TS. Determination of estrogen receptor by monoclonal antireceptor antibody in aspiration biopsy cytology from breast carcinoma. Am J Clin Pathol. 1988 89 24-29. 

FIGURE 21.21 Fine-needle aspiration biopsy of a breast mass. (A) Papanicolaou stain. (B) Diff-Quik smears of cytomorphologically invasive ductal carcinoma. (C) HER2/neu moderate complete strong membranous staining (score 2+) (FIP). At follow-up fluorescence in situ hybridization showed amplification. Such cytology specimens must be formalin fixed. 

B14. Burton, G., Flowers, J., Cox, E., Geisinger, K., Leight, G., Georgiade, G., Dent, G., and McCarty, K., Jr., Monoclonal antiestrogen receptor antibody (H222) in fine needle aspiration cytologies of breast cancer A predictive marker of response to hormonal therapy. Breast Cancer Res. Treat. 6, 164 (1985). 

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