A cytohistological correlation: Proliferative breast disease with atypia

Breast fine-needle aspiration cytology (FNAC) is a rapid, cost-effective, and minimally invasive diagnostic procedure. The diagnosis of a proliferative breast disease with atypia (PBDA) is established based on the presence of areas with disordered cellular arrangement and mildly discerned cytological features. We have aimed to explore the cytohistological correlation of PBDA on FNAC.

A review of the hospital database was undertaken to retrieve cases of breast FNAC diagnosed as PBDA between January 2011 and September 2020.

A total of 3125 breast FNAC specimens were examined, and 107 (3.4%) of them received the diagnosis of PBDA. A total of 68 PBDA cases were included in this cytohistological evaluation. The risk of malignancy was 44%. Except for one case, all of the invasive or microinvasive carcinomas were grade 1 or 2 malignancies according to the Nottingham grading system of breast cancers. The result of a repeat FNAC of the case with a poorly differentiated invasive breast cancer was reported as a high-grade malignancy. A statistically significant correlation was observed between older age and malignant outcome (P < 0.001).

This is one of the largest datasets of cases with PBDA. Based on the advanced age of the patient, and relevant clinical and radiological information, cytopathological diagnosis of PBDA may prompt the clinician to take further action.