Evaluation of cytological morphologic criteria and AgNOR expression in male breast lesions

Fine needle aspiration (FNA) breast smears from 81 male patients have been examined in our laboratory between 1988 and 1994. The cytological criteria for diagnosing male breast lesions and the expression of nuclear organizer regions were evaluated. Of the 81 cases examined cytologically, 50 cases were proven cytologically and histologically to be inactive gynaecomastia, two cases showed florid gynaecomastia and there were 10 adenocarcinomas; in the 17 cases in which no cytological evidence of gynaecomastia or malignancy was found, the histological diagnosis was gynaecomastia in 13 and there was one case of mastopathy; in two cases suspicious of malignancy on cytology the histological examination proved to be florid gynaecomastia in one case and the other showed an adenocarcinoma. The absolute specificity of FNA in this study was 74.28%, the complete specificity 98.5%, the absolute sensitivity 90.9% and the complete sensitivity 100%. The overall accuracy was 97.5%, the positive predictive value 91.66% and the negative predictive value 98.5%. In all cases of male breast carcinoma, AgNOR mean value was > or = 3; thus, it appears that AgNOR mean value 3 could be used as a cut-off value between benign and malignant male breast lesions. Our experience suggests that FNA is an acceptable procedure for the investigation of male breast lesions.