BREAST CYTOLOGY: AN EXAMPLE OF STRONG SYNERGY BETWEEN MORFOLOGY AND CLINICAL NEEDS

Breast Fine Needle Aspiration Cytology (FNAC) represents first choice diagnostic tool to determine mammographic lesions and clinically palpable breast nodules. FNAC is affected anyway by a certain degree of subjectiveness, that is more evident with the so- called “grey zone” cases (the ones not clearly benign or not clearly malignant) and when there are some doubts about material adequacy. These situations may create some misunderstandings between clinicians and pathologists with possible over or undertreatment for patients. The need for clear communication is extremely important, but it becomes a priority in senology because of the multidisciplinary aspects of the field. For this reasons a breast cytology reporting system has been proposed since 1993 within a U.K. mammographic breast screening programme. From our experience we think only a cytological exam with well demonstrated and well documented quality which satisfies those criteria suggested by guidelines will be able to play a key role in patients’ clinical management. It will allow reducing as much as possible diagnostic biopsies on benign lesions and frozen sections to confirm malignant lesions.We believe that a good quality cytology can provide an important and relevant contribution to define breast lesions’ nature without using other invasive procedures and to obtain in most cases good material for subsequent molecular investigations. Cytological approach to breast lesions was also validated in Breast Unit of Trieste during EUSOMA certification visit.