RESUMO
OBJECTIVE: To determine the usefulness of image cytometry on fine needle aspirates from patients with fibrocystic changes (FCCs) to assess the subsequent risk of breast cancer. STUDY DESIGN: Thirty-five hundred archival cases with fine needle aspiration (FNA) biopsy were assessed to select nonproliferative FCCs of the breast (500 cases), also classified as type 1 (FCC I). DNA evaluation was analyzed by means of image cytometry on ductal epithelial cells and on apocrine metaplastic cells; 97 quantifications were performed. Cytometric variables investigated were: DNA ploidy, G0/G1 peak of diploid nuclei, S-phase fraction, 5cER, 2cDI and coefficient of variation. Two groups each with 15 years of follow-up were formed: Simple pathology (SP), fibrocystic changes alone; associated pathology (AP), FCCs plus breast cancer. Each was studied separately and compared. RESULTS: In SP cases the average ploidy was 2.2 for epithelial cells and 4.2 for apocrine cells. The proportion of G0G1 diploid nuclei was 100%. In the study of AP, the average ploidy was 2.2 for epithelial ductal cells and 4.1 for apocrine ones, for a slight increase in SPF. Ductal cells were diploid, while apocrine cells were tetraploid, with statistical significance of P < .05. For the epidemiologic study we calculated the proportion of patients with FCC I who developed cancer by referring to a historical cohort study, obtaining a relative risk of 0.7. CONCLUSION: Our results prove that DNA image cytometry applied on FNA cytology is a very useful, minimally invasive and reliable tool to determine higher activity and risk for development of breast cancer in FCC I and thus to establish the need for closer follow-up of these patients. In addition, apocrine metaplastic cells of the breast display a tetraploid DNA histogram, while the other karyometric variables remain in the range of normality.
