What do my lab test reports indicate?

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Posted on Mon, 3 Jul 2017 in Blood Disorders
Question: I am 53 years old recently menopausal, with fibrocystic breasts. Recently on my annual mammogram an oval well defined lesion was seen with cluster of microcalcifications in it. This lesion was there years. Before but never questioned and dis not have calcifications. Doctor did a stereotactic FNAC as nothing was seen on ultrasound and she suspected fibrocystic area/change. The FNAC report is as follows:
The aspirates show approximately seven groups and clusters of benign epithelial and myoepithelial cells. Small fragments of adipose tissue and calcifications are also present.
Result: benign epithelial leaion C2
The report is not specific at all and although the breast surgeon said its fibrocystic change. shouldn't apocrine and foam cells be present?
What could the pathologist mean by benign epithelial leaion based on this report ?
doctor
Answered by Dr. Hardik Sanghvi 16 hours later
Brief Answer:
It does not show any evidence of malignancy (cancer).

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

You have fibrocystic disease. But on mammogram there is micro calcification. Microcalcifications raise the suspicion of malignancy so further investigation are required.

You have gone through FNAC and it shows benign epithelial lesion. It is a part of fibrocystic disease. There is no evidence of malignancy right now. So further action is required.

You should go for regular follow up mammography. Because it can turn in to malignancy in future but right now there is nothing to worry.

Fibrocystic disease is non specific and all findings are not present in all cases. So don't worry about that.

Hope I have answered your question.If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.Wish you a very good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Hardik Sanghvi 18 minutes later
It can turn into malignancy in the future!
If this is benign how could you say it will turn into malignancy in the future when it is a known fact that fibrocyatic disease is not a pre-malignant condition especially when there is no atypia detected.
Your answer is not directed at my question as i already know it is not malignant and i can read the report well myself, and i asked about apocrine and foam cells in fibrocystic changes which you have not answeres.
Please refrain from giving such bold statements and scare patiens and people who would not know any better about a benign finding turning into cancer later !!!! If a microcalcification is cancerous it will be from the start not turn into cancer later !
If you were unable to address my question with proper details, please have the courtsey to allow another expert to answer it.
It is disappointing that on this website now, customers are more informed and aware than the experts. Customers should not be manipulated like this by paying for an answer from someone who is not qualified to address it. This is outrageous.
doctor
Answered by Dr. Hardik Sanghvi 16 minutes later
Brief Answer:
Apocrine and foam cells are not always present in all case.

Detailed Answer:
Hi, dear
I can understand your concern.

I have already told that all findings are not present in all cases.

Foam cells and apocrine cells are seen in fibrocystic disease. But in your FNAC your pathologist did not find it. And it happens frequently. Your pathologist find benign epithelial cells only.

Don't apply everything you read from internet in your case. You have micro calcification and there are many premalignant condition in which microcalcifications are seen. So it's wise to go for follow up. I have not said that it will turn in to malignancy. But it can turn in few cases. So just go for follow up mammography.

Customer have knowledge from internet. We have knowledge by doing day to day practice. So don't apply everything you read from internet.

In my patients if I don't find all findings of benign lesion and patients have microcalcifications on mammography then I will advise for follow up.
It's up to you whether you want to go for follow up or not.

Hope I have answered your question.If you still have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.
Wish you very good health.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Hardik Sanghvi 3 hours later
I appreciate your follow-up andwer. My Doctor said the follow-up will be just the annual mammogram as the microcalcifications were already biopsied and were benign.

So based on your practice, an area of benign microcalcifications without any kind of atypia would likely turn into cancer in the future ?

I just entered menopause recently, would these microcalcifications be related ?
doctor
Answered by Dr. Hardik Sanghvi 12 hours later
Brief Answer:
Purely benign microcalcifications will not turn into malignancy.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

Benign microcalcifications will not turn into malignancy. But you have gone through FNAC and only seven groups of benign cells are seen. Ofcourse that are benign but there is a chance that material may not be representative and there may be few atypical cells which are not taken for FNAC.

FNAC has its own limitations. Don't trust it blindly. Clinical correlations and other factors should be kept in mind.

So in my opinion it should be considered as probably benign. Most of the cases will not turn into malignancy. But on safe side you should go for follow up mammography after 6 months to see the changes in that area. If there are no any changes in mammography after six months then annual mammography should be done.

All microcalcifications are not cancerous. Normal aging, inflammation , post trauma all can lead to microcalcifications formation. So it can be due to your age. But we should keep watch on it.

That's all from my side.

If you still have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.

Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Hardik Sanghvi 5 hours later
How many groups of cells are enough for FNAC validity then? Seven is not enough ?

The doctor said one year because the area is representative since the sample sent for cytology included microcalcifications as stated in the report. FNAC was done stereotactic through mammogram.
doctor
Answered by Dr. Hardik Sanghvi 17 hours later
Brief Answer:
Less then 10 groups of cells considered low cellularity.

Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.

For breast epithelial lesion six group or clusters of cells are considered as cut off point for adequate sampling.

But generally less then 10 groups are considered as low cellularity and there are few chance that it can be false negative.

You have benign lesion and nothing to worry but in my opinion for safe side you should go for follow up mammography once after six month. Afterward annual check up is ok. This is our routine practice.

Everyone has different opinion. Medicine is not like mathematics where everyone answer is same. Your doctor is also right. I gave my opinion.

Now it's up to you.

Hope I have answered your question.If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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