BREAST CYTOPATHOLOGY

38 2. Non-neoplastic and Proliferative Lesions
Radiation-Induced Changes
Clinical Features
• Radiation-induced changes are not uncommon because a
larger proportion of patients are undergoing breastconserving
therapies that may include adjuvant radiation.
• The effects of radiation are noted not only in any residual
carcinoma but also in the nonneoplastic mammary tissue.
Cytomorphologic Characteristics (Figure 2.20)
• Smears usually paucicellular
• Small epithelial fragments, often lobular in nature, with
significant cytologic atypia (vacuolated cytoplasm, enlarged
nuclei, prominent nucleoli) and degenerative changes
Figure 2.20. Radiation atypia. Partially intact breast lobule with
markedly enlarged, pleomorphic nuclei displaying macronucleoli.
The patient had a history of radiation treatment for ductal carcinoma.
Although the morphologic changes are too bizarre to represent
lobular carcinoma, such cases require a careful interpretation
when patients have previously resected breast cancer. (Smear,
Papanicolaou.)