Forty-eight patients with breast carcinoma were subjected to four quadrant fine needle aspiration (FNA) cytology examination of the ipsilateral and contralateral breast in an attempt to detect any accompanying benign proliferative lesion. Mastectomy of ipsilateral and open biopsy of contralateral breast provided material for histopathological study. Cytological evidence of epithelial proliferation was found in 8 (16.6%) cases which included atypical lobular hyperplasia (ALH), lobular neoplasia in-situ (LNIS), atypical ductal hyperplasia (ADH), and proliferative disease without atypia (PDWA). In lobular proliferative lesions, cytological smears showed configurations of cells that resembled filled up or expanded lobular units. The cytology was not distinctive enough to distinguish the sub-types of lobular proliferations. Likewise, the presence of ductal alterations could be suggested by cytological study but the distinction of proliferative disease without atypia (PDWA) from atypical ductal hyperplasia (ADH) was not possible on a cytological basis.
Seventy-eight symptomatic females without palpable breast lumps were subjected to bilateral four quadrant fine needle aspiration cytology. Cytological evidence of an epithelial proliferative lesion was seen in 44 of these cases. Based on the cytological evidence of proliferation, the site for open biopsy was determined. Histopathological study of the breast biopsies in these patients showed proliferative disease without atypia (PDWA) in 40 cases, atypical ductal hyperplasia (ADH) in two, atypical lobular hyperplasia (ALH) in one and ADH with ALH in one case. Cytology was thus useful in establishing the presence of proliferative activity, commenting on the extent of proliferation, and thereby roughly mapping out the area of the breast most suitable for biopsy. On cytological grounds, it was not possible to distinguish the atypical hyperplastic lesions from the proliferative diseases without atypia.