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Research ArticleOriginal Article
Open Access

Analysis of false positive and false negative cytological diagnosis of breast lesions

Awatif A. Jamal and Ibrahim Mansoor
Saudi Medical Journal January 2001, 22 (1) 67-71;
Awatif A. Jamal
Department of Histopathology, King Abdul Aziz Univerisity Hospital, Jeddah, Kingdom of Saudi Arabia. Tel. +966 2 687 1195. Fax. +966 2 695 2538. E-mail: [email protected]
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Ibrahim Mansoor
Department of Histopathology, King Abdul Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
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Abstract

OBJECTIVE: To study the reasons for interpretive errors in false negative and false positive diagnosis of breast carcinoma on fine needle aspiration cytology material.

METHODS: We reviewed only those cases in which cytohistological discrepancies were found, where the cytologic material was abnormal and to some extent misinterpreted or both.

RESULTS: There was only one false negative case (false negative fraction 0.32%) proved histologically as ductal carcinoma and four false positive cases (false positive fraction 1.2%); 2 fibroadenoma; 1 fibrocystic disease; and 1 stromal fibrosis. Smears of the two false positive fibroadenoma cases showed very high cellularity, overcrowded clusters and frequent stripped nuclei. The fibrocystic case showed tight clusters of apocrine cells and sheets of loosely aggregated macrophages that were over interpreted. Smears of the false negative ductal carcinoma was hypocellular overall, and the cells showed minimal nuclear pleomorphism.

CONCLUSION: Overcrowded clusters and hypercellular smears should be carefully assessed for uniformity of cells and detailed nuclear and cytomorphological features. If the full-blown malignant cytomorphological changes are not visible, a diagnosis of suspicious or inconclusive should be made and frozen section recommended before surgery. Hypocellularity and relatively nuclear monomorphism are the reasons for failure to diagnose malignant breast lesions. Careful attention should be paid to extreme nuclear monomorphism and absence of naked bipolar cells. A cytologically atypical or suspicious diagnosis together with positive radiological and clinical findings should suggest a diagnosis of malignancy.

  • Copyright: © Saudi Medical Journal

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Saudi Medical Journal: 22 (1)
Saudi Medical Journal
Vol. 22, Issue 1
1 Jan 2001
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Analysis of false positive and false negative cytological diagnosis of breast lesions
Awatif A. Jamal, Ibrahim Mansoor
Saudi Medical Journal Jan 2001, 22 (1) 67-71;

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Analysis of false positive and false negative cytological diagnosis of breast lesions
Awatif A. Jamal, Ibrahim Mansoor
Saudi Medical Journal Jan 2001, 22 (1) 67-71;
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© 2025 Saudi Medical Journal Saudi Medical Journal is copyright under the Berne Convention and the International Copyright Convention.  Saudi Medical Journal is an Open Access journal and articles published are distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC). Readers may copy, distribute, and display the work for non-commercial purposes with the proper citation of the original work. Electronic ISSN 1658-3175. Print ISSN 0379-5284.

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