Interesting case and thank for sharing.

I once did a lot of breast FNA when I was cytofellow at USC where all breast mass lesions would be referred to cytopathologists to do FNA. Now days FNA is rare to be used for the primary evaluation of breast lesions at Magee and most large medical centers in the US. If we do not consider the money, cost-effect, it will be easy for pathologists to read breast core bx than FNA.

For this case I woud like to sign out:

-Negative for maligancy.

-clusters of apocine cells.

-Suggestive of fibrocystic changes.

Comment:

Mostly it is a lesion with cystic papillary apocine metaplasia even though the papillary lesion cannot be completely excluded.

FNA combined with clinical impression and imaging finding (Triple test) is highly accurate. If one of the parameters is discordant, surgical biopsy is warranted. Benign Triple test should return for follow up in 3 to 6 months. (write this part in your comment for all FNA breast cases to protect yourself).

 In fact 3 cm cystic lesion should be excisioned. Of cause I will not write this sentence in my report. Pathologists do not need to take all the responsblity for patient care. We take care of the part we should have.