FNAC

I have had two breast fnac smears.  Right breast says cell rich aspirates, composed of dual population of epithelial and myoepithelial cells seen in baranching monolayered sheets, fronds and as bare nuclei in the background.  Many bypolar stromal cells and pink fibroconnective tissue stroma seen.  No atypical cells seen.

Left says cell-rich aspirate of dual population of epithelial and myoepithelial cells with many bare nuclei in the background.  In addition a few cohusive clusters of cells showing mild degree of nuclear atypia.

Surgeon wishes to remove both lumps.  Can anyone interpret the above results for me and advise whether a second opinion should be sought.  I am 44 year old female with no family history of cancer.  I have been advised I have bilateral mastalgia and multiple lumps.  The biopsied lumps are fairly tender and feel hormonal.

[PaulMD]

Hi.

The left breast biopsy harbors atypia, which may increase the risk of developing invasive cancer, or may indeed harbor an area of DCIS or invasive cancer somewhere in the lump not sampled by the FNA.  I believe that your surgeon also thinks this way, and this is why he recommends removing both lumps just to be sure that there are no other focus of invasive cancer in the other parts of the lumps.

Do not be confounded by all the technical descriptions of the cells.  The right lump biosy just means that the lesion is benign, while the left also shows a benign character but with the focus of atypical cells which may increase the risk of developing invasive cancer.  

Regards.

[mia56]

Thanks for this.  The lumps are being removed third week of August - does this time frame sound OK to you.  By the way the right lump was Category 2 and left was Category 3.  Is is possible for totally benign lumps to contain cells with mild degree of nuclear atypia.