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 language | English (US) |
|---|---|
| Pages (from-to) | 233-238 |
| Number of pages | 6 |
| Journal | Cancer |
| Volume | 102 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 25 2004 |
| Externally published | Yes |
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Keywords
- Breast
- Carcinoma
- Cytology
- Diagnosis
- Nipple discharge
- Paget disease
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
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 journal › Article
}
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
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U2 - 10.1002/cncr.20379
DO - 10.1002/cncr.20379
M3 - Article
VL - 102
SP - 233
EP - 238
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 4
ER -