BREAST CYTOPATHOLOGY

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152 5. Metastatic and Secondary TumorsLevine PH, Zamuco R, Yee HT: Role of fine-needle aspirationcytology in breast lymphoma. Diagn Cytopathol 2004, 30:332–340.Singh NG, Kapila K, Dawar R, Verma K: Fine needle aspirationcytology diagnosis of lymphoproliferative disease of the breast.Acta Cytol 2003, 47:739–743.Sneige N, Zachariah S, Fanning TV, Dekmezian RH, Ordonez NG:Fine-needle aspiration cytology of metastatic neoplasms in thebreast. Am J Clin Pathol 1989, 92:27–35.
6Breast Ductal LavageTo obtain nipple aspiration fluid (NAF), a pump and/or asyringe connected to a suction cup is applied to the nippleand the aspirated fluid is collected using a capillary tube. Thisprocedure yields NAF in 59%–99% of women. A volume of20–30μl of fluid can be obtained (range 1–200). About 77%of the cells of NAF are foam cells of macrophage derivation,and only 13% are ductal epithelial cells (median 120 cells/duct). Criteria for evaluation of NAF were developed in themid-1970s and are similar to the criteria used for evaluationof breast FNA material. The cytologic findings in NAF from2,701 volunteer women with no family history of breast cancerand no breast carcinoma at the time of enrollment were analyzedprospectively. The overall incidence of breast cancer inthis cohort was 4.4% after median follow-up of 12.7 years. Inthis study, both incidence and relative risk of breast cancerincreased with increasing severity of cytologic diagnosis ofthe NAF (Table 6.1). Although the relative risk of breastcancer associated with abnormal NAF was reduced in anupdated analysis of the data, these results have generatedmuch interest in the use of mammary cytology for the evaluationof breast cancer risk.Some investigators have detected in NAF factorsassociated with mammary neoplasia; others have performedproteomic analysis and molecular evaluation of NAF,but there is no clinical application for these findings atpresent.153
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Breast Cytopathology
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Syed Z. Ali, MDDepartment of Pathol
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To my parentsGul Bano (late) and Ma
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viiiForewordthis volume to rejuvena
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xSeries Prefaceand form the framewo
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xiiPrefacecarefully selected high-r
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ContentsForeword by Dorothy L. Rose
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2 1. Introduction and Technical Asp
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10 1. Introduction and Technical As
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2Non-neoplastic andProliferative Le
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18 2. Non-neoplastic and Proliferat
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Figure 2.26. Lactational change. Hy
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58 3. Benign and Borderline TumorsC
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60 3. Benign and Borderline TumorsF
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68 3. Benign and Borderline Tumors
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84 3. Benign and Borderline TumorsG
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86 4. Primary Malignant Tumors• M
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88 4. Primary Malignant TumorsFigur
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92 4. Primary Malignant TumorsHisto
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100 4. Primary Malignant TumorsFigu
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Page 152 and 153: 5Metastatic and SecondaryTumorsMeta
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Page 160 and 161: BFigure 5.9. (B) Metastatic papilla
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Page 170 and 171: 156 6. Breast Ductal LavageFigure 6
Page 176 and 177: 162 6. Breast Ductal Lavagecarcinom
Page 178 and 179: 164 6. Breast Ductal LavageKrishnam
Page 180 and 181: 166 IndexApocrine carcinomain axill
Page 182 and 183: 168 IndexDuctal carcinoma (cont.)fi
Page 184 and 185: 170 IndexFine-needle aspiration, of
Page 186 and 187: 172 IndexLung cancer, 138metastatic
Page 188 and 189: 174 IndexPapilloma (cont.)invasive
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BREAST CYTOPATHOLOGY

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