BREAST CYTOPATHOLOGY
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12 1. Introduction and Technical Aspects
Fine-needle aspiration of normal breast.
• Usually scant cellularity
• Always cohesive ductal fragments (few to no
lobules)
• Uniform round nuclei, no crowding, and
minimal overlap
• Dense chromatin, small inconspicuous nucleoli
• Accompanying fibroadipose tissue fragments
Fine-needle aspiration cytologic criteria for
breast carcinoma.
• Architectural characteristics (best evaluated at
×25–×40 magnification)
• Cellular morphology (best evaluated at ×100–
×400 magnification)
• General characteristics
High cellularity
Cellular enlargement
High nucleus to cytoplasm ratios
Nuclear hyperchromasia
Macronucleoli (less often observed)
Cellular/nuclear monomorphism (not always
present)
Eccentric nuclear placement
Cellular dishesion with single isolated
epithelial cells
Mitoses/karyorrhexis
Cellular crowding/overlap
Lack of myoepithelial cells
Necrosis
• Specific characteristics
Small cell size with cytoplasmic lumina/
vacuoles (lobular carcinoma)
Pleomorphic naked nuclei with macronucleoli
(medullary carcinoma)
Abundant mucin and capillary tangles
(colloid carcinoma)
Rigid, open-ended tubules (tubular
carcinoma)
Note: See Figure 1.7.