FNAB

[Jannoona]

what does nipple ulcer, signs of subareolar duct papillomatosis mean in a FNAB. Would still this be considered as a skin biospy since the nipple was scrubbed and sampled?

[BhumikaMD]

Hi,

It does not mean that you are at an increased risk of developing breast cancer. It means that you have to watch out for any change in the size of the lesions and report them to your doctor.

Regular would be to do a breast self examination every one to two weeks and get a periodic evaluation by your doctor every 4-6 months.

You could ask your breast specialist for the correct technique of breast self examination.

Let us know if you have any other doubts and post us about how you are doing.

Regards.

[Jannoona]

Does that mean I am at risk for developing breast cancer or paget's? How regular, is every day, month is OK. One last thing, when I do a self exam, I normally do a stand to the mirror, look for obviouse changes, nipple, shape, and size, I palpate the lump but infrequently as I have been told touching it too much is not good.
What else shall I do..

[BhumikaMD]

Hi,

You need to relax and discuss this with one of the breast specialist's you trust the most and you are comfortable with.

You need to carry out regular breast self examinations, and follow up with your specialist regularly or as and when advised and report any abnormal features that you notice to your doctor.

You would need to get repeat investigations as and when advised by your doctor.

If you are still apprehensive, you could talk to your surgeon about getting the fibroadenoma removed surgically.

Let us know about how you are doing and if you have any other doubts.

Post us about what you have decided finally.

Regards.

[Jannoona]

My doctor was suspecting Paget's disease, The 1st FNAB I did says:
MILDLY ATYPICAL CELLS, HOWEVER THE CHRAMOTINE PATTERN DOES NOT LOOK MALIGNANT. NIPPLE ULCER WITH SIGN OF SUBAREALAR PAPILLOMATOSIS

After 5 days the doctor asked my to redo the FNAB which says:
CYTOLOGY SMEAR SHOWS A FEW CLUSTERS OF UNIFORM DUCTAL EPTHELIAL CELLS. THERE ARE FRAGEMENTS OF SPINDLE CELL STROMAL TISSUE. THIS IS CONSISTENT WITH FIBROADENOSIS.

I am having those symptoms for almost 13 month till now which are:
Lump in my right breast to the lower router side of it. It did not grow, change in texture as I feel it. It is smooth, and solid, but movable like a marble.

I have sore right nipple, it feels very hard to the left side of it. It is pinkish or redish on it's top. No nipple discharge. I think my nipple has been damaged because of the FNAB, the doctor inserted the nipple deep into the middle of my nipple to my breast as he was suspecting a lump underneeth it.

My breasts both look in same shape, size, no changes in color or skin.

I did an ultrasound that confirmed this is fibroadenoma, and that I had two in the right breast.

I am not sure, why I keep worrying, although I saw more than 8 doctors who are surgeons, they keep telling me it's OK. I am afraid it is paget's and because it is a rare disease they do not know much about it.
I am 33 years old, I have infertility issues, married with no children. No history of family BC.

WHAT SHALL I DO

[BhumikaMD]

Hi,

A fine needle aspiration biopsy is the examination of cells and not intact tissue - so it would be considered a FNAB sample if the nipple was scrubbed and sampled.

Could you post the full report to us?

The report that you mention implies that FNAB detected signs of 'subareolar duct papillomatosis' which is a benign tumour which clinically resembles paget's disease.

Let us know about the clinical features that you are having and if you have any other doubts.

Post us about what your breast specialist has advised.

Regards.