Fine-needle aspiration cytology in locally advanced breast adenocarcinoma

A case with complete response to preoperative chemotherapy in association with granulomatous inflammatory reaction

M. J. Costa, G. Stewart, E. A. Perez, J. E. Goodnight

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Preoperative chemotherapy for locally advanced breast carcinoma (stage III(A,B)) is increasingly utilized demonstrating a 70 to 95% objective response and 15 to 35% complete response. A 70-yr-old woman presented with a 9 cm left upper outer quadrant breast mass associated with overlying skin redness and a 2.5 cm left axillary mass. Fine-needle aspiration cytology (FNA) showed a pleomorphic adenocarcinoma in both the breast and axilla. Following three courses of chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF), the patient had a dramatic clinical reduction of tumor, reduction of serum CA 15-3 from 161 to 64 U/ml, and underwent a modified radical mastectomy and axillary dissection. The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes. This case illustrates two points concerning preoperative chemotherapy for locally advanced breast cancer: (1) The role of FNA v. tissue biopsy is examined. Positive cytology must be conclusive since, as in this case, no viable carcinoma may be present after therapy. (2) Chemotherapy induced host tissue reaction has not been extensively studied. This case showed a remarkable granulomatous reaction in association with tumor elimination. Since this reaction was not present on the original aspiration cytology slides, the chemotherapy treatment must have induced this reaction. Mechanisms for creating this effective host response need further investigation.

Original languageEnglish (US)
Pages (from-to)357-361
Number of pages5
JournalDiagnostic Cytopathology
Volume10
Issue number4
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

Fine Needle Biopsy
Cell Biology
Adenocarcinoma
Breast
Drug Therapy
Breast Neoplasms
Modified Radical Mastectomy
Neoplasms
Axilla
Methotrexate
Fluorouracil
Cyclophosphamide
Dissection
Lymph Nodes
Carcinoma
Biopsy
Skin
Therapeutics
Serum

Keywords

  • Cancer
  • Fine-needle aspiration
  • Granulomatous inflammation
  • Tissue response

ASJC Scopus subject areas

  • Anatomy

Cite this

Fine-needle aspiration cytology in locally advanced breast adenocarcinoma : A case with complete response to preoperative chemotherapy in association with granulomatous inflammatory reaction. / Costa, M. J.; Stewart, G.; Perez, E. A.; Goodnight, J. E.

In: Diagnostic Cytopathology, Vol. 10, No. 4, 1994, p. 357-361.

Research output: Contribution to journalArticle

@article{3837e6322ad246f3aa6ac999860da21a,
title = "Fine-needle aspiration cytology in locally advanced breast adenocarcinoma: A case with complete response to preoperative chemotherapy in association with granulomatous inflammatory reaction",
abstract = "Preoperative chemotherapy for locally advanced breast carcinoma (stage III(A,B)) is increasingly utilized demonstrating a 70 to 95{\%} objective response and 15 to 35{\%} complete response. A 70-yr-old woman presented with a 9 cm left upper outer quadrant breast mass associated with overlying skin redness and a 2.5 cm left axillary mass. Fine-needle aspiration cytology (FNA) showed a pleomorphic adenocarcinoma in both the breast and axilla. Following three courses of chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF), the patient had a dramatic clinical reduction of tumor, reduction of serum CA 15-3 from 161 to 64 U/ml, and underwent a modified radical mastectomy and axillary dissection. The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes. This case illustrates two points concerning preoperative chemotherapy for locally advanced breast cancer: (1) The role of FNA v. tissue biopsy is examined. Positive cytology must be conclusive since, as in this case, no viable carcinoma may be present after therapy. (2) Chemotherapy induced host tissue reaction has not been extensively studied. This case showed a remarkable granulomatous reaction in association with tumor elimination. Since this reaction was not present on the original aspiration cytology slides, the chemotherapy treatment must have induced this reaction. Mechanisms for creating this effective host response need further investigation.",
keywords = "Cancer, Fine-needle aspiration, Granulomatous inflammation, Tissue response",
author = "Costa, {M. J.} and G. Stewart and Perez, {E. A.} and Goodnight, {J. E.}",
year = "1994",
doi = "10.1002/dc.2840100413",
language = "English (US)",
volume = "10",
pages = "357--361",
journal = "Diagnostic Cytopathology",
issn = "8755-1039",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Fine-needle aspiration cytology in locally advanced breast adenocarcinoma

T2 - A case with complete response to preoperative chemotherapy in association with granulomatous inflammatory reaction

AU - Costa, M. J.

AU - Stewart, G.

AU - Perez, E. A.

AU - Goodnight, J. E.

PY - 1994

Y1 - 1994

N2 - Preoperative chemotherapy for locally advanced breast carcinoma (stage III(A,B)) is increasingly utilized demonstrating a 70 to 95% objective response and 15 to 35% complete response. A 70-yr-old woman presented with a 9 cm left upper outer quadrant breast mass associated with overlying skin redness and a 2.5 cm left axillary mass. Fine-needle aspiration cytology (FNA) showed a pleomorphic adenocarcinoma in both the breast and axilla. Following three courses of chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF), the patient had a dramatic clinical reduction of tumor, reduction of serum CA 15-3 from 161 to 64 U/ml, and underwent a modified radical mastectomy and axillary dissection. The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes. This case illustrates two points concerning preoperative chemotherapy for locally advanced breast cancer: (1) The role of FNA v. tissue biopsy is examined. Positive cytology must be conclusive since, as in this case, no viable carcinoma may be present after therapy. (2) Chemotherapy induced host tissue reaction has not been extensively studied. This case showed a remarkable granulomatous reaction in association with tumor elimination. Since this reaction was not present on the original aspiration cytology slides, the chemotherapy treatment must have induced this reaction. Mechanisms for creating this effective host response need further investigation.

AB - Preoperative chemotherapy for locally advanced breast carcinoma (stage III(A,B)) is increasingly utilized demonstrating a 70 to 95% objective response and 15 to 35% complete response. A 70-yr-old woman presented with a 9 cm left upper outer quadrant breast mass associated with overlying skin redness and a 2.5 cm left axillary mass. Fine-needle aspiration cytology (FNA) showed a pleomorphic adenocarcinoma in both the breast and axilla. Following three courses of chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil (CMF), the patient had a dramatic clinical reduction of tumor, reduction of serum CA 15-3 from 161 to 64 U/ml, and underwent a modified radical mastectomy and axillary dissection. The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes. This case illustrates two points concerning preoperative chemotherapy for locally advanced breast cancer: (1) The role of FNA v. tissue biopsy is examined. Positive cytology must be conclusive since, as in this case, no viable carcinoma may be present after therapy. (2) Chemotherapy induced host tissue reaction has not been extensively studied. This case showed a remarkable granulomatous reaction in association with tumor elimination. Since this reaction was not present on the original aspiration cytology slides, the chemotherapy treatment must have induced this reaction. Mechanisms for creating this effective host response need further investigation.

KW - Cancer

KW - Fine-needle aspiration

KW - Granulomatous inflammation

KW - Tissue response

UR - http://www.scopus.com/inward/record.url?scp=0028242953&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028242953&partnerID=8YFLogxK

U2 - 10.1002/dc.2840100413

DO - 10.1002/dc.2840100413

M3 - Article

VL - 10

SP - 357

EP - 361

JO - Diagnostic Cytopathology

JF - Diagnostic Cytopathology

SN - 8755-1039

IS - 4

ER -