Is the cytologic evaluation helpful in the diagnosis of phylloid breast cancer?

Purpose: To assess the reliability of cytologic diagnosis of phylloid breast cancer, performed on cells sampled by ultrasound-guided fine needle agobiopsy.

Methods and materials: In a period of 7 years, we performed 2801 ultrasound-guided fine needle agobiopsies on breast lesions. Among these, 18 were suspected to be phylloid cancers (BI-RADS C3/4). All lesion were surgically excised and histologically examined.

Results: We have found a cyto-histological correlation in 10 lesions, with 1 border-line phylloid and 1 malignant. 1 lesion was a sarcoma originating from pectoralis major muscle. 6 lesions were benign (5 fibroadenomas and 1 epitelial hyperplasia in a complex mastopathy). In our experience, cytology PPV is 55%, with an overestimation of 33%.

Conclusions: If assessed by an expert cytopathologist, the outcomes of a ultrasound-guided fine needle agobiopsy is comparable to core-biopsy in the presurgical diagnosis of phylloid breast cancer.