Russian Journal of OncologyRussian Journal of OncologyРоссийский онкологический журнал1028-99842412-9119Eco-Vector19744610.17816/onco197446Clinical investigationsКлинические исследованияResearch ArticleLobular carcinomas of the breast: cytological diagnosticsДольковые карциномы молочной железы: цитологическая диагностикаhttps://orcid.org/0000-0001-9981-23487250-6259GrigorukOl’ga G.ГригорукОльга Григорьевна
Russian Federation

Dr. Sci. (Biol.), Associate Professor

д.б.н., доцент

cytolakod@rambler.ruMoskvinaTat’jana A.МосквинаТатьяна Александровна
Russian Federation

MD

врач

tanhellita2010@bk.ruhttps://orcid.org/0000-0002-7222-0657BazulinaLarisa M.БазулинаЛариса Михайловна
Russian Federation

MD

врач

lardoc69@mail.ruSinkinaTat’jana V.СинкинаТатьяна Владимировна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

tatyanasin@mail.ruVihljanovIgor’ V.ВихляновИгорь Владиславович
Russian Federation

MD, Dr. Sci. (Med.)

д.м.н.

akod@zdravalt.ruAltai Regional Oncological DispensaryАлтайский краевой онкологический диспансерAltai State Medical UniversityАлтайский государственный медицинский университет1405202227283920702202314022023Copyright ©; 2023, Григорук О.Г., Москвина Т.А., Баулина Л.М., Синкина Т.В., Вихлянов И.В.Copyright ©; 2023, Grigoruk O.G., Moskvina T.A., Михайловна L.M., Sinkina T.V., Vihljanov I.V.2023Григорук О.Г., Москвина Т.А., Баулина Л.М., Синкина Т.В., Вихлянов И.В.Grigoruk O.G., Moskvina T.A., Михайловна L.M., Sinkina T.V., Vihljanov I.V.https://creativecommons.org/licenses/by-nc-nd/4.0/https://rjonco.com/1028-9984/article/view/197446

AIMS: To estimate potentialities of cytological diagnostics of different types of lobular carcinomas of the breast while outpatient examination.

MATERIALS AND METHODS: The data of cytological investigations of 444 patients with carcinoma, which were detected by fine-needle aspiration biopsy, were studied. Traditional cytological diagnostics, as well as the liquid-based technique of preparation of patterns were used, staining of patterns according to the Pappenheim and Papanicolaou methods. A standard protocol for immunocytochemical reactions was used.

RESULTS: Lobular carcinoma was detected in 15 patients. Types of lobular carcinomas were verified by cytological method were retrospectively identified.

Classical, solid and tubular types of lobular carcinoma (n=7,46.7%; n=5,33.3%; n=1,6.7%) differed from unspecified breast carcinomas. In the classical type, vacuoles with a target-like inclusion (probably a drop of mucin) were a significant feature. In the solid type, the absence of complexes with a large number of separately located similar tumor cells was noticed. The tubular type was distinguished by the presence of tubular structures. The liquid-based technique helps to differentiate lobular and unspecified carcinoma using an immunocytochemical reaction with E-cadherin.

CONCLUSION: The results of the study indicate that lobular carcinomas of the breast are 3.4% of all breast carcinomas. Taking into consideration the differences in prognosis, it is important to differentiate between lobular and unspecified ductal carcinoma at the outpatient level of diagnostics, as this is deciding for treatment strategy choice.

Цель. Оценить возможности цитологической диагностики различных типов дольковых карцином молочной железы при амбулаторном обследовании пациенток.

Материалы и методы. Изучены данные цитологического исследования 444 пациенток с установленной при тонкоигольных аспирационных биопсиях карциномой. Использованы традиционная цитологическая диагностика, а также жидкостная методика приготовления препаратов, окрашивание препаратов по методу Паппенгейма и Папаниколау. Применяли стандартный протокол проведения иммуноцитохимических реакций.

Результаты. Дольковая карцинома установлена у 15 пациенток. Ретроспективно определены варианты дольковых карцином, верифицированных цитологическим методом. Классический, солидный и тубулярный типы дольковой карциномы (n=7,46,7%; n=5,33,3%; n=1,6,7%) отличались от неспецифицированных карцином молочной железы. При классическом типе значимым признаком явились вакуоли с мишеневидным включением (вероятно, каплей муцина). При солидном типе отмечено отсутствие комплексов при большом количестве раздельно расположенных однотипных клеток опухоли. Тубулярный вариант характеризовался присутствием тубулярных структур. Жидкостная методика позволяет дифференцировать дольковую и неспецифицированную карциному при проведении иммуноцитохимической реакции с использованием E-кадгерина.

Заключение. Дольковые карциномы молочной железы составили 3,4% всех карцином молочных желёз. Учитывая различия в прогнозе, на амбулаторном этапе диагностики важно дифференцировать дольковую и неспецифицированную протоковую карциному, так как это имеет решающее значение для выбора стратегии лечения.

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