Dayal Seema, Krishna Mani, Kannaujia Sanjay Kumar, Singh Seema
Department of Pathology, Uttar Pradesh University of Medical Sciences, Etawah, Uttar Pradesh, India.
J Microsc Ultrastruct. 2021 Jan 22;9(3):119-124. doi: 10.4103/JMAU.JMAU_19_20. eCollection 2021 Jul-Sep.
Breast lesions extend from benign to malignant ones. The National Cancer Institute recommended categories for the diagnosis of breast cytology. There are some lesions in the breast which are called intermediate or gray lesions. It includes C3 (atypical, probably benign) and C4 (suspicious, favor malignant) which needs to be evaluated.
This study was conducted in the Department of Pathology, Uttar Pradesh University of Medical Sciences, Saifai, Etawah (Uttar Pradesh). Fine-needle aspiration cytopathology (FNAC) was the diagnostic tool. The present study was undertaken to determine the gray lesions of the breast and its correlation with histopathology and other associated parameters. Immunohistochemistry was applied where ever necessary. One hundred and fifty one cases of gray lesions of the breast were included.
C3 was seen in 85 (56.29%) and C4 in 66 (43.70%) patients. The maximum number of patients was of 31-40, (33.77%) years age group, the youngest patient was 12-year-old female, whereas the oldest was 86 years male. Histopathology evaluation confirmed malignancy in 35 (23.17%) cases, and infiltrating ductal carcinoma was the frequent malignancy (24 [68.5%]). Sensitivity, specificity, positive predictive value, and negative predictive value of C4 category for the diagnosis of malignancy were, respectively, 81.48%, 50%, 68.7%, and 64.2%.
FNAC is an excellent diagnostic tool. It has some limitations, especially with the gray lesions, which may lead to miss interpretation in diagnosis, so a scope of mistake to the cytopathologist is always there. These lesions need to be evaluated because of the risk of malignancy. However, gray lesions can be reduced by cytology followed by histopathology examination along with ancillary radiological investigations such as mammography and ultrasonography.
乳腺病变涵盖从良性到恶性的各类情况。美国国立癌症研究所推荐了乳腺细胞学诊断的分类。乳腺中存在一些被称为中间型或灰色病变的情况。它包括需要评估的C3（非典型，可能为良性）和C4（可疑，倾向恶性）。
本研究在北方邦医学科学大学赛法伊分校（北方邦埃塔瓦）病理学系开展。细针穿刺细胞病理学（FNAC）为诊断工具。本研究旨在确定乳腺灰色病变及其与组织病理学和其他相关参数的相关性。必要时应用免疫组织化学方法。纳入了151例乳腺灰色病变病例。
85例（56.29%）患者为C3，66例（43.70%）患者为C4。患者数量最多的年龄组为31 - 40岁（33.77%），最年轻的患者为12岁女性，最年长的为86岁男性。组织病理学评估证实35例（23.17%）为恶性，浸润性导管癌是最常见的恶性肿瘤（24例[68.5%]）。C4类别对恶性肿瘤诊断的敏感性、特异性、阳性预测值和阴性预测值分别为81.48%、50%、68.7%和64.2%。
FNAC是一种出色的诊断工具。它存在一些局限性，尤其是对于灰色病变，可能导致诊断中的错误解读，因此细胞病理学家始终存在误判的可能性。由于存在恶性风险，这些病变需要进行评估。然而，通过细胞学检查，随后进行组织病理学检查以及辅助的放射学检查如乳腺X线摄影和超声检查，可以减少灰色病变。
