A 17-year-old female underwent Fine Needle Aspiration cytology (FNAC) for a lump in the breast which was non-tender, firm and mobile. Which of the following features would suggest finding of a benign breast disease?(AIIMS November 2014, May 2013)
Ans. b. Tightly arranged ductal epithelial cells with dyseohesive bare nuclei (Ref: Winfred Grays diagnostic cytopathology 2/e p279-280)Non-tender, firm and mobile breast lump in a female of age 17 years is suggestive of fibroadenoma, in which tightly- arranged ductal epithelial cells with dyscohesive bare nuclei are seen on FNAC. (AIIMS May 2013 repeat)Fibroadenoma:Diagnostic findings on needle biopsy consist of:Abundant stromal cells which appear as bare bipolar nucleiSheets of fairly uniform-size epithelial cells that are typically arranged in either an antler like pattern or a honeycomb pattern.Foam cells and apocrine cells may also be seen, although these are less diagnostic features.FibroadenomaMC benign tumor of female breastQMC age group: 15-30 yearsQKnown as breast mouseQEtiology: Increased sensitivity of focal areas of breast tissue to estrogenQPathology:Encapsulated spherical lesion, composed of fibrous and glandular tissueQArise from interlobular stroma, stromal cells can be monoclonal or polyclonalTypes of FibroadenomaPericanalicularIntracanalicular* Hard* Due to proliferation of connective tissue inside the elastic lamina* Soft* Due to proliferation of connective tissue outside the elastic laminaClinical Features:Painless, slowly growing solitary mobile lump in the breast (Breast mouse)QDiagnosis:Characteristic popcorn calcificationQ on mammographyIOC is FNACQDiagnostic findings on needle biopsy consist ofAbundant stromal cells which appear as bare bipolar nucleiSheets of fairly uniform-size epithelial cells that are typically arranged in either an antler like pattern or a honeycomb pattern.Foam cells and apocrine cells may also be seen, although these are less diagnostic features.Treatment:No treatmentQ is necessary when diagnosis is confirmed.Excision biopsy is the treatment of choice for suspicious lesionQ and for cosmetic indications.