Cell blocks of breast FNAs frequently allow diagnosis of invasion or histological classification of proliferative changes

Two major limitations of breast fine needle aspiration (FNA) compared with core needle biopsies (CNB) are the inability to determine whether a cancer is invasive and to classify proliferative lesions. We studied 40 consecutive "rapid cell blocks" from breast FNAs with surgical pathology,follow-up to test whether cell blocks can overcome these limitations. Of 25 carcinomas, invasion could be identified in the cell block sections in 11 (44%). One cystosarcoma phyllodes was suspected based on the cell block sections. Cell blocks from 12 of 14 benign breast FNAs showed sufficient cells to assign a histologic diagnosis of no hyperplasia (I case, confirmed on follow-tip) and usual hyperplasia (11 cases; confirmed in eight of 11 on follow-up). Specific histologic diagnoses included intraductal papilloma (2 cases), and in situ lobular neoplasia (2 cases). Cell blocks complement smears and monolayers and appear to overcome major limitations of breast FNA.

与粗针穿刺活检（CNB）相比，乳腺细针穿刺抽吸（FNA）的两个主要局限性在于无法确定癌症是否为浸润性以及无法对增生性病变进行分类。我们研究了40例连续的乳腺细针穿刺抽吸的“快速细胞块”，并结合手术病理及随访来检验细胞块是否能够克服这些局限性。在25例癌中，11例（44%）在细胞块切片中可识别出浸润。根据细胞块切片怀疑1例为叶状囊肉瘤。14例乳腺良性细针穿刺抽吸中的12例细胞块显示有足够的细胞，可做出无增生的组织学诊断（1例，随访证实）和普通增生的诊断（11例；11例中有8例随访证实）。具体的组织学诊断包括导管内乳头状瘤（2例）和原位小叶肿瘤（2例）。细胞块是涂片和单层细胞的补充，似乎克服了乳腺细针穿刺抽吸的主要局限性。