未见恶性肿瘤细胞

坏死物   考虑结核

但乳腺结核 少见

这次细胞成分很多，细胞比较单一，核大小不等。倾向肿瘤，需排除癌。

 This will be an intetresting case to discuss breast FNA in general. The first 3 photos are not very cellular, in contrast, the last 3 photos are very cellular and the cells are discohesive, also show some pleomorphism, it is very worrysome for malignancy. Again, sorry for the staining comment, I think this is a H&E stain again, it is kind of fusy and not crystal clear (good Pap stain usually does a better job).

 I would like to bring the issue of breast FNA. I learned some of the status of Breast FNA in China from Dr. CZhao, who gave an excellent lecture on that topic in this year's Chinese Cytology Meeting in Guangzhou.

I am still curious to know the following aspects: 1) Are anyone familiar with the "Triple test of Breast"? 2) How common is a breast lesion or mass evaluted by FNA first? 3) What are the common senerios breast FNA was ordered by the clinicians in China; 4)If you call a breast FNA positive for carcinoma, what the surgeon will do in China? Please partipate in the discussion. Thanks!

我想在此请教一些乳腺细针穿刺标本的问题，我曾经在中国跟赵博士学过这方面的知识，赵在今年广州中国细胞学会议上做了精彩的专题讲座。我有以下几个问题：1.有谁熟悉 "Triple test of Breast"? 2) 首次通过细针穿刺的病人确诊的多吗，有多大估计意义? 3) What are the common senerios breast FNA was ordered by the clinicians in China; 4)如果穿刺报癌，临床医生会怎么处理？请参与讨论，谢谢。

 1、考虑为乳腺癌（至于是小叶癌，还是导管癌，细胞学分类容易出错，结合6幅图，只是倾向于小叶癌可能性要大点）。

2、乳腺肿块细针吸取细胞学，如果肯定报告乳腺癌，完全没必要再做术中快速。我们是完全接纳阚秀教授的观点，乳腺癌的细胞学报告是分两种情况报告给临床的，一是肯定乳腺癌（细胞异型性明显且细胞量足够肯定诊断）的就报“乳腺癌”；另一种情况就是考虑为乳腺癌（通常是细胞异型性不明显，即使细胞量丰富、排列特殊，包括大多数小叶癌，高分化小细胞型的导管癌等），就报“考虑为乳腺癌，请结合术中快速切片进一步确诊”。在实际工作中，我们的临床医生都是如此执行的，所以我们报告的“乳腺癌”必须绝对准确。