FINE NEEDLE ASPIRATION CYTOLOGY OF IRRADIATED BREAST – VALUE AND POTENTIAL DIAGNOSTIC PITFALLS
Autori:
Mirjana Marković-Glamočak, Mirna Sučić, Šimun Križanac, Suncica Ries, Koraljka Gjadrov-Kuvezdic, Dubravka Boban
Sažetak
Sažetak. Opisane su morfološke promjene stanica žljezdanog epitela dojke nakon poštedne operacije karcinoma dojke i zračenja. Cilj rada bio je utvrditi mogućnost citološke procjene morfoloških promjena palpabilnih lezija u ostalom dijelu ozračene dojke. Analizirali smo citološke razmaze punktata u 50 bolesnica nakon operacije i zračenja. U 12 bolesnica, od kojih se u 2 citološki radilo o karcinomu, a u 10 o suspektnim promjenama koje su perzistirale, učinjena je biopsija i patohistološka potvrda. Dva citološki nađena karcinoma potvrđena su i patohistološki. Recidiv je patohistološki dokazan i u 3/ 10 (33,3 %) citološki suspektnih punktata, dok se u ostalih 7/10 (66,7%) suspektnih nalaza radilo o benignoj promjeni (2 blage duktalne proliferacije, 2 floridne duktalne proliferacij e, 3 adenoze). Ostale bolesnice praćene su klinički i citomorfološki nakon 4-5 mjeseci do nestanka promjena. U periodu praćenja nije došlo do recidiva bolesti. Citodijagnostika je korisna u procjeni i praćenju palpabilnih promjena dojke nakon zračenja iako je njezina uloga ograničena. Citolog mora znati je li i kada bolesnica bila zračena. Nalaz promijenjenih stanica nakon perioda kad tih promjena nije bilo upućuje na recidiv bolesti.
Summary
Summary. Morphologic changes in glandular epithelium of the breast after quadrantectomy of the breast carcinoma and radiotherapy are described. The aim of the study was to establish the possibilities of cytologic assessment of morphological changes in palpable lesions in the residual breast tissue. Fine needle aspirates of 50 patients after surgery and radiotherapy of the breast carcinoma were analyzed. Biopsy and pathohistologic verification were performed in 12 patients. Carcinoma was cytologically found and confirmed pathohistologically in two cases. Recurrence was pathohistologically confirmed in 3/10 (33.3%) cytologically suspect aspirates, while in the remaining 7/10 (66.7%) suspect findings benign changes were established (2 mild ductal proliferations, 2 florid ductal proliferations, 3 cases of adenosis). The patients were followed-up clinically and cytomorphologically. No relapse was noted in the follow up period. Although its role is limited, fine needle aspiration cytology is useful in the assessment and follow-up of palpable changes after irradiation. A cytologist shoud be informed on whether and when a patient underwent irradiation. The finding of the changed cell after the period without changes points to the relapse of the disease.
