Cytologic score and DNA-image analysis in the classification of borderline breast lesions: A prospective study on 47 fine-needle aspirates
✍ Scribed by Giorgio Gherardi; Cristina Marveggio
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 132 KB
- Volume
- 20
- Category
- Article
- ISSN
- 8755-1039
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✦ Synopsis
We prospectively evaluated the accuracy of the cytologic score system developed by Masood et al. combined with DNA-image analysis in the subclassification of 47 fine-needle aspiration samples with cytologic features of borderline breast lesions. Cytologic scores ranged between 12-18. All cases underwent surgical excision of the lesion, and histology revealed 24 cases of florid hyperplasia, 8 of atypical hyperplasia, and 11 noninvasive and 4 invasive ductal carcinomas. DNA-image analysis demonstrated 33 diploid and 14 aneuploid cases. Diploid samples were divided into slowly proliferating (S ϩ G2/M Յ 13%) and rapidly proliferating (S ϩ G2/M Ͼ 13%) cases. By considering florid hyperplasia a ''low-risk'' lesion and by amalgamating atypical hyperplasia, and in situ and invasive ductal carcinoma in the category of ''high-risk'' lesions, the positive predictive value of a score value Ͼ16 was 100%. In cases scoring Յ16, the slowly proliferating pattern had a negative predictive value of 95%, while the aneuploid and rapidly proliferating patterns had a positive predictive value of 100% and 63%, respectively. We conclude that a combination of cytologic score evaluation and DNA-image analysis is very useful in differentiating ''low-risk'' from ''high-risk'' cases in the field of breast borderline lesions, thus improving the impact of fine-needle aspiration diagnosis on patient management.