Australian Society of CytologyCase 1 - 2007
Answer and Discussion
Ductal Carcinoma
Answer
Smear Description:
Smears shows 3-D “cannon-balls” (Fig 7) and papillary groups. (Fig 1-2) Single malignant ductal cells were present in the bloody background. The malignant cells have high N: C ratio with coarse and irregular chromatin. Chromatin margination is seen. (Fig 5-7) Pleomorphism and hyperchromasia were present.
Cannabalism can be seen. (Fig 3-4)
Cytoplasm is cyanophilic and dense with well-defined border.
Necrotic debris (tumour diathesis) and foamy macrophages were present in the bloody background. (Fig 2 and 4) The smear shows lack of bipolar nuclei. (Fig 1-5)
Cytological diagnosis of Ductal Carcinoma was made.
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| Figure 1 | Figure 2 | Figure 3 |
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| Figure 7 |
Patient underwent ultrasound examination. A core biopsy was performed on the nodule present.
Histological Description
Core Biopsy shows invasive ductal carcinoma, which measure 7 mm in maximum dimension. Grade 3.
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| Figure 8 | Figure 9 | Figure 10 |
Discussion
Infiltrating Ductal Carcinoma
Ductal Carinoma is a common type of breast cancer. It arises from the lining duct and spread to the surrounding tissue.
Risk factors include family history, increasing age, lack of breast feeding, late menopause, overweight, useage of exogenous hormones, alcoholic and genetic mutation, excess radiation exposure and lack of physical activities.
Signs and Symptoms of breast cancer includes:
- Lump present in the breast or underarm
- Change in shape and size of breast
- Nipple discharge or redness present
In order to diagnosis and manage breast cancer, The Triple Test is available. It includes mammography, clinical examination and pathological examination.
Treatment and prognosis for breast cancer is determined by
- The tumour size
- Stage and grade of cancer
- Hormone receptor status
Treatment which is dependent of the pathological examination are available in the form of radiation, chemotherapy and surgery.
Reference
DeMay, R., The Art and Science of Cytopathology, ASCP, 1996
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