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    What does this FNAC report indicate?

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Posted on Fri, 7 Jul 2017 in Cancer
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. Deepak Sundriyal 2 hours later
Brief Answer:
Hello. Apocrine cells may not be there

Detailed Answer:
Hello dear. I have gone through the details. So the biopsy report is consistent with what we call fibrocystic changes and there is actually nothing to fear. With time and after menopause, the estrogenic stimulus is lost and the glands shows involution and regression and hence apocrine and foam crlls may not be seen. This can also be termed as aberrations of normal development and involutions. This is perfectly ok. Any breast lesion which is not a cancer is termed as benign epithelial lesion and hence the pathologist used this term. Hope it is clear.
Thanks and regards
Feel free to ask further
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Deepak Sundriyal 32 minutes later
Thank you doctor for the detailed response. The doctor said the FNAC is accurate in this case as the sample shows calcifications so they got the right spot and there is no need for core biopsy. Would you agree that the FNAC would be sensitive enough in this case ?

So it is possible for fibrocyatic area not to show any foam or apocrine cells ? is it possible for this lesion to be a fibroadenoma or is the pathology for that different than my report?
doctor
Answered by Dr. Deepak Sundriyal 2 hours later
Brief Answer:
Hello. The fnac is ok

Detailed Answer:
Hello dear. So the fnac is accurate and all the parameters mentioned are also consistent with your age and a benign lesion. It is not gibroadenoma but only fibrocystic changes. You need not to worry. Biopsy is not required.
Thanks and regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepak Sundriyal 8 hours later
Thank you for your concern, i am not worried, i would just like to know more details.
The breast FNAC reports i have seen are usually specific, why would my report be non-specific and not mentioning fibrocystic change ?
Benign epithelial lesion can be any benign disease not necessairly fibrocystic, so why wouldn't my report be more specific as to what this lesion/calcifications are due to?
doctor
Answered by Dr. Deepak Sundriyal 7 hours later
Brief Answer:
Hello. It is just a way of reporting

Detailed Answer:
Hello dear. It is just a way of reporting the pathology and can ary from institutions to another institution and bwtween different dkctoray. But final conclusion is same, either benign or malignant lesion. Report is acceptable.
Thanks and regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Deepak Sundriyal 24 hours later
Thanks doctor. One last question, in what percentage of fibrocystic changes apocrine and foam cells seen ?
My mother has been in menopause for less than a year, is it enough for loss of apocrine and foam cells in her fibrocystic breast tissue ?
doctor
Answered by Dr. Deepak Sundriyal 1 hour later
Brief Answer:
Hello. Most of the cases in menopause dont show apocrine

Detailed Answer:
Hello dear. Exact percentage is not known as this is not relevant after menopause, but mostly dont show after menopause.
Thanks and regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1546 Questions

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