Diagnostic value of nipple cytology: Study of 466 cases

Bobbi Pritt, Yijun Pang, Marybeth Kellogg, Timothy St. John, Abdelmonem Elhosseiny

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

BACKGROUND. Nipple discharge/scraping cytology is a simple, noninvasive method that complements patient assessment. Despite low reported sensitivities for detecting malignancy, the authors predicted that this method would provide important diagnostic information when applied to patients with nonphysiologic nipple discharge or eczematous nipple lesion. METHODS. From 1995-2002, 466 case specimens from 395 patients were evaluated by nipple discharge or scraping cytology. Of the 98 patients with abnormal cytologic findings, histologic follow-up was available for 45 cases (39 patients). After review, each case was categorized as negative or positive for malignancy. Cytologic findings were compared with the findings of subsequent biopsy or excision of the affected duct or nipple lesion. RESULTS. Of the 13 cases of in situ or invasive carcinoma diagnosed by histology, 11 had positive cytology (sensitivity, 85%). Two malignant cases were not represented by preceding cytology and one case with positive cytology failed to demonstrate malignancy after a subsequent biopsy was performed (specificity, 97%). Clinically, all but one case of malignancy was associated with a serosanguinous discharge or eczematous nipple lesion. The cytology of all malignant cases showed dyshesive epithelial cell groups and single cells with prominent nucleoli in a bloody background. The positive predictive value for cytology was 92% and the negative predictive value was 94%. CONCLUSIONS. Cytologic examination of nipple discharge and nipple lesion scrapings is highly specific and sensitive in the detection of carcinoma when applied to patients with unilateral serosanguinous nipple discharge or an eczematous nipple lesion.

Original languageEnglish (US)
Pages (from-to)233-238
Number of pages6
JournalCancer
Volume102
Issue number4
DOIs
StatePublished - Aug 25 2004
Externally publishedYes

Fingerprint

Nipples
Cell Biology
Neoplasms
Carcinoma
Biopsy
Histology
Epithelial Cells
Nipple Discharge

Keywords

  • Breast
  • Carcinoma
  • Cytology
  • Diagnosis
  • Nipple discharge
  • Paget disease

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pritt, B., Pang, Y., Kellogg, M., St. John, T., & Elhosseiny, A. (2004). Diagnostic value of nipple cytology: Study of 466 cases. Cancer, 102(4), 233-238. https://doi.org/10.1002/cncr.20379

Diagnostic value of nipple cytology : Study of 466 cases. / Pritt, Bobbi; Pang, Yijun; Kellogg, Marybeth; St. John, Timothy; Elhosseiny, Abdelmonem.

In: Cancer, Vol. 102, No. 4, 25.08.2004, p. 233-238.

Research output: Contribution to journalArticle

Pritt, B, Pang, Y, Kellogg, M, St. John, T & Elhosseiny, A 2004, 'Diagnostic value of nipple cytology: Study of 466 cases', Cancer, vol. 102, no. 4, pp. 233-238. https://doi.org/10.1002/cncr.20379
Pritt B, Pang Y, Kellogg M, St. John T, Elhosseiny A. Diagnostic value of nipple cytology: Study of 466 cases. Cancer. 2004 Aug 25;102(4):233-238. https://doi.org/10.1002/cncr.20379
Pritt, Bobbi ; Pang, Yijun ; Kellogg, Marybeth ; St. John, Timothy ; Elhosseiny, Abdelmonem. / Diagnostic value of nipple cytology : Study of 466 cases. In: Cancer. 2004 ; Vol. 102, No. 4. pp. 233-238.
@article{76dd3de1e48f4f84aeeac8c693c89733,
title = "Diagnostic value of nipple cytology: Study of 466 cases",
abstract = "BACKGROUND. Nipple discharge/scraping cytology is a simple, noninvasive method that complements patient assessment. Despite low reported sensitivities for detecting malignancy, the authors predicted that this method would provide important diagnostic information when applied to patients with nonphysiologic nipple discharge or eczematous nipple lesion. METHODS. From 1995-2002, 466 case specimens from 395 patients were evaluated by nipple discharge or scraping cytology. Of the 98 patients with abnormal cytologic findings, histologic follow-up was available for 45 cases (39 patients). After review, each case was categorized as negative or positive for malignancy. Cytologic findings were compared with the findings of subsequent biopsy or excision of the affected duct or nipple lesion. RESULTS. Of the 13 cases of in situ or invasive carcinoma diagnosed by histology, 11 had positive cytology (sensitivity, 85{\%}). Two malignant cases were not represented by preceding cytology and one case with positive cytology failed to demonstrate malignancy after a subsequent biopsy was performed (specificity, 97{\%}). Clinically, all but one case of malignancy was associated with a serosanguinous discharge or eczematous nipple lesion. The cytology of all malignant cases showed dyshesive epithelial cell groups and single cells with prominent nucleoli in a bloody background. The positive predictive value for cytology was 92{\%} and the negative predictive value was 94{\%}. CONCLUSIONS. Cytologic examination of nipple discharge and nipple lesion scrapings is highly specific and sensitive in the detection of carcinoma when applied to patients with unilateral serosanguinous nipple discharge or an eczematous nipple lesion.",
keywords = "Breast, Carcinoma, Cytology, Diagnosis, Nipple discharge, Paget disease",
author = "Bobbi Pritt and Yijun Pang and Marybeth Kellogg and {St. John}, Timothy and Abdelmonem Elhosseiny",
year = "2004",
month = "8",
day = "25",
doi = "10.1002/cncr.20379",
language = "English (US)",
volume = "102",
pages = "233--238",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Diagnostic value of nipple cytology

T2 - Study of 466 cases

AU - Pritt, Bobbi

AU - Pang, Yijun

AU - Kellogg, Marybeth

AU - St. John, Timothy

AU - Elhosseiny, Abdelmonem

PY - 2004/8/25

Y1 - 2004/8/25

N2 - BACKGROUND. Nipple discharge/scraping cytology is a simple, noninvasive method that complements patient assessment. Despite low reported sensitivities for detecting malignancy, the authors predicted that this method would provide important diagnostic information when applied to patients with nonphysiologic nipple discharge or eczematous nipple lesion. METHODS. From 1995-2002, 466 case specimens from 395 patients were evaluated by nipple discharge or scraping cytology. Of the 98 patients with abnormal cytologic findings, histologic follow-up was available for 45 cases (39 patients). After review, each case was categorized as negative or positive for malignancy. Cytologic findings were compared with the findings of subsequent biopsy or excision of the affected duct or nipple lesion. RESULTS. Of the 13 cases of in situ or invasive carcinoma diagnosed by histology, 11 had positive cytology (sensitivity, 85%). Two malignant cases were not represented by preceding cytology and one case with positive cytology failed to demonstrate malignancy after a subsequent biopsy was performed (specificity, 97%). Clinically, all but one case of malignancy was associated with a serosanguinous discharge or eczematous nipple lesion. The cytology of all malignant cases showed dyshesive epithelial cell groups and single cells with prominent nucleoli in a bloody background. The positive predictive value for cytology was 92% and the negative predictive value was 94%. CONCLUSIONS. Cytologic examination of nipple discharge and nipple lesion scrapings is highly specific and sensitive in the detection of carcinoma when applied to patients with unilateral serosanguinous nipple discharge or an eczematous nipple lesion.

AB - BACKGROUND. Nipple discharge/scraping cytology is a simple, noninvasive method that complements patient assessment. Despite low reported sensitivities for detecting malignancy, the authors predicted that this method would provide important diagnostic information when applied to patients with nonphysiologic nipple discharge or eczematous nipple lesion. METHODS. From 1995-2002, 466 case specimens from 395 patients were evaluated by nipple discharge or scraping cytology. Of the 98 patients with abnormal cytologic findings, histologic follow-up was available for 45 cases (39 patients). After review, each case was categorized as negative or positive for malignancy. Cytologic findings were compared with the findings of subsequent biopsy or excision of the affected duct or nipple lesion. RESULTS. Of the 13 cases of in situ or invasive carcinoma diagnosed by histology, 11 had positive cytology (sensitivity, 85%). Two malignant cases were not represented by preceding cytology and one case with positive cytology failed to demonstrate malignancy after a subsequent biopsy was performed (specificity, 97%). Clinically, all but one case of malignancy was associated with a serosanguinous discharge or eczematous nipple lesion. The cytology of all malignant cases showed dyshesive epithelial cell groups and single cells with prominent nucleoli in a bloody background. The positive predictive value for cytology was 92% and the negative predictive value was 94%. CONCLUSIONS. Cytologic examination of nipple discharge and nipple lesion scrapings is highly specific and sensitive in the detection of carcinoma when applied to patients with unilateral serosanguinous nipple discharge or an eczematous nipple lesion.

KW - Breast

KW - Carcinoma

KW - Cytology

KW - Diagnosis

KW - Nipple discharge

KW - Paget disease

UR - http://www.scopus.com/inward/record.url?scp=4143116819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4143116819&partnerID=8YFLogxK

U2 - 10.1002/cncr.20379

DO - 10.1002/cncr.20379

M3 - Article

C2 - 15368315

AN - SCOPUS:4143116819

VL - 102

SP - 233

EP - 238

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -