Diagnostic Role of the Presence of Red Blood and Epithelial Cells in Nipple Discharge CytologySundara Rajan S1*, Verma R1, Kelly J2, Cullen A3, Turton P1, Achuthan R1 and Horgan K1
- *Corresponding Author:
- Sundara Rajan S
Research Fellow in Breast Surgery
Breast Secretariat, Leeds General Infirmary
Great George Street, Leeds, LS1 3EX, UK
Tel: 0044113 2265496
E-mail: [email protected]
Received Date: July 29, 2013; Accepted Date: November 29, 2013; Published Date: December 01, 2013
Citation: Sundara Rajan S, Verma R, Kelly J, Cullen A, Turton P, et al. (2013) Diagnostic Role of the Presence of Red Blood and Epithelial Cells in Nipple Discharge Cytology. J Cytol Histol 4:199. doi:10.4172/2157-7099.1000199
Copyright: © 2013 Sundara Rajan S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Management of nipple discharge (ND) is variable reflecting the lack of a uniformly accepted
assessment policy. The aim of this study was to determine the common underlying pathology in patients presenting with ND as well as to evaluate the diagnostic role of red blood cells (RBC) and epithelial cells in the nipple cytology (NC).
Methodology: Electronic data base held at Leeds Teaching Hospitals NHS Trust was searched to identify all
the patients who underwent Hadfield’s (open diagnostic major duct excision) procedure for ND from January 2004 to December 2009. We included only patients with ND as the primary symptom and excluded those with any underlying palpable or radiological abnormality.
Results: Hadfield’s procedure was performed in 120 cases (Median age=49 years; range=20-88). The final
histology showed benign changes (duct ectasia/hyperplasia and fibrocystic changes) in most (37.5%), followed by intra-ductal papilloma (32.5%), normal (16.6%), malignant (10.9%) and atypical (2.5%) changes in the rest. The presence of RBC in NC was 87% sensitive to detect any underlying pathology and 69% sensitive to predict malignancy at the expense of specificity. However, epithelial cells were found to be neither sensitive nor specific enough to detect underlying pathology or malignancy.
Conclusion: The aetiology remains benign in most patients presenting with ND in the absence of any underlying palpable or radiological abnormality. Even in patients without an underlying radiological abnormality, diagnostic
surgery should be offered if RBC is present in the nipple cytology.