Breast lesions during lactation diagnosed by fine needle aspiration cytology

Abstract EN

Background : the breast function as a secretory gland during pregnancy and lactation due to the interaction of estrogen, progesterone and other pituitary hormones.

The ductless of the terminal duct lobular unit become hyperplastic and manifest cytoplasmic vacuolization and luminal secretion.

Occasionally this change results in a discrete nodule, called a lactating adenoma (LA), which is difficult to distinguish clinically from a malignancy.

Patients and method : A review of the clinical and cytological features of 60 lactating women present with breast lesions, over the period from August 2005- May 2010 in the Main Referral Center for Early Detection of Breast Tumors, Medical City, Baghdad Teaching Hospital.

Those who present with a breast mass underwent aspiration using 10ml disposable syringe (20-22gauge), the aspirated material spread on slides and Received Aug.

2010 fixed with 95 % alcohol and stained with Pap-stain and examined under light microscope.

Accepted Feb.

2011 Results : clinicocy to logical study of 60 lactating women presented with breast lesions including the age, chief complaint, the site of the lesion ; the main morphological types of the lesions, and the main cytological findings and the difficulty in diagnosing malignancy during lactation.

The mean age of the whole cases is 30.05 years; while the mean age for the six cases that were diagnosed as carcinoma during lactation is 37.5 years.

The main cytological features that differentiate breast carcinoma from benign conditions during lactation are : crowding and overlapping of nuclei., dyscohesion and enlarged, pleomorphic nuclei, irregular nuclear membrane, coarse nuclear chromatin and mitosis.

Conclusions :the majority of breast lesions during lactation are benign.

The physiologic changes associated with lactation make it difficult to recognize, diagnose new breast pathology and delay in diagnosis of breast carcinoma is common due to the difficulty in feeling masses.

A diagnosis of carcinoma during lactation can be made by Fine-needle aspiration cytology ; however, caution should be exercised in interpreting cytology specimens in this setting, because cellular features can mimic malignancy.

The main cytological features that differentiate breast carcinoma from benign conditions during lactation are crowding and overlapping of nuclei, dyscohesion of the cells and enlarged pleomorphic nuclei with irregular nuclear membrane, coarse nuclear chromatin and mitosis.