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How is the procedure performed and in what cases is it necessary?
What does cytology of nipple discharge show?
Cytological examination of nipple discharge is one of the most informative and demanded diagnostic methods in mammology. It makes it possible to determine the presence of pathological changes in breast tissues at the cellular level, revealing inflammation, benign neoplasms, and malignant tumors. The method is characterized by minimal invasiveness, does not require complex preparation, and possesses high accuracy—up to 95%. The examination is particularly important for the early diagnosis of oncological processes when external symptoms may not yet be evident. It helps the physician determine the further management plan for the patient: whether additional tests are needed, dynamic observation is required, or treatment should be initiated.
When is the examination prescribed?
The most common reason for prescribing the test is nipple discharge not associated with breastfeeding. Bloody, purulent, or discharge from only one breast warrants particular caution. A physician may also refer a patient for cytology upon the detection of lumps or areas with a suspicious structure during palpation, ultrasound (US), or mammography. Other indications include: nipple retraction or a change in its shape, ulcerations, fissures, crusting, scaling in the areola area, itching, soreness, or redness, monitoring after surgical interventions on the breast, and dispensary observation of patients in the high-risk group for breast cancer (for example, due to hereditary predisposition or hormone-dependent diseases).
How to prepare for the test?
Preparation for cytology is quite simple but is important for the reliability of the result. If the woman is of reproductive age, the optimal time for the test is considered to be the 7-10 day of the menstrual cycle, when the hormonal background is most stable. It is advisable to:
• Avoid saunas, steam rooms, and hot baths.
• Do not use cosmetic products on the breast area (including creams and deodorants).
• Avoid active stimulation of the breast (e.g., during massage).
• Limit alcohol and heavy food consumption.
Wear clean cotton underwear on the day of the procedure. The intake of hormonal drugs, anticoagulants, vitamin E and some other agents may be temporarily discontinued upon the physician's recommendation. If there are results from previous analyses (ultrasound, mammography, biopsy)—it is best to bring them along. It is also important to inform the physician about chronic diseases, pregnancy, medication intake, and any complaints, even if they seem insignificant.
How is the material collected?
If nipple discharge is present, the physician gently collects it with a sterile swab or glass slide after preliminary antiseptic treatment of the nipple. The collected material is then applied to a slide and sent to the laboratory. If there is no discharge, but pathology is suspected, a puncture technique is used: fine-needle aspiration biopsy (FNAB). Cells are extracted from the suspicious lesion using a fine needle under palpation or ultrasound guidance. In the case of deeply located or dense areas, a core needle biopsy may be used, which yields a more abundant sample, thereby increasing the informativeness of the examination. After the puncture, the puncture site is treated, a sterile dressing is applied, and the patient is advised to apply cold compresses to reduce possible swelling.
Rehabilitation
Cytology is usually well tolerated. However, after a puncture, the following may be observed: slight soreness or a feeling of heaviness, swelling, hematoma at the puncture site, and minor discomfort when moving the arm. During the first 24 hours, it is advisable to avoid physical exertion, heat procedures, and wetting the puncture area. If necessary, a painkiller may be taken, excluding medications based on acetylsalicylic acid (aspirin), to avoid provoking increased bleeding. If severe pain, fever, purulent discharge, or other alarming symptoms appear, it is imperative to consult a physician.
Question and Answer
1) How long does the breast cytology test take?
The results are usually ready in 3–5 business days. With an urgent request, it is faster, within 1–2 days. If confirmatory diagnostics are necessary, for example, immunohistochemistry, the time frame increases to 7–10 days. The time to receive the report is affected not only by the type of examination but also by laboratory workload, case complexity, and sample quality.
2) What diseases does cytology detect?
Cytology provides valuable information in the following conditions:
• Inflammatory processes: mastitis, lactostasis, abscess, tuberculosis of the breast.
• Hormonal dysfunctions: hyperprolactinemia, galactorrhea, ectopic lactation.
• Benign neoplasms: fibroadenomas, cysts, intraductal papillomas.
• Precancerous conditions: atypical ductal and lobular hyperplasia, lobular neoplasia.
• Malignant tumors: ductal, lobular, medullary, inflammatory carcinoma, etc.
The method can also indicate the presence of suspicious cells that require more detailed study. This is especially important in cases of asymptomatic disease or equivocal results from other tests.
3) What does cytology show in cancer?
In a sample suspicious of oncopathology, the laboratory physician may detect:
• Atypical cells with enlarged nuclei.
• Disruptions in the structure of the cytoplasm and nuclear membrane.
• Cell polymorphism (variety of shapes and sizes).
• Signs of infiltrative growth.
• High mitotic activity (cell division).
Cytology does not always provide a definitive diagnosis, but in most cases, it allows for timely suspicion of cancer and referral of the patient for further investigation—histology, CT, MRI, or surgical biopsy. The sensitivity of the method for oncological diseases is 85–98%, and the specificity is up to 95%.
Conclusions: This is a reasonably safe examination. It effectively detects early forms of breast oncology and other pathologies. There is no need to fear it or refuse it if the physician suggests it.
What does cytology of nipple discharge show?
Cytological examination of nipple discharge is one of the most informative and demanded diagnostic methods in mammology. It makes it possible to determine the presence of pathological changes in breast tissues at the cellular level, revealing inflammation, benign neoplasms, and malignant tumors. The method is characterized by minimal invasiveness, does not require complex preparation, and possesses high accuracy—up to 95%. The examination is particularly important for the early diagnosis of oncological processes when external symptoms may not yet be evident. It helps the physician determine the further management plan for the patient: whether additional tests are needed, dynamic observation is required, or treatment should be initiated.
When is the examination prescribed?
The most common reason for prescribing the test is nipple discharge not associated with breastfeeding. Bloody, purulent, or discharge from only one breast warrants particular caution. A physician may also refer a patient for cytology upon the detection of lumps or areas with a suspicious structure during palpation, ultrasound (US), or mammography. Other indications include: nipple retraction or a change in its shape, ulcerations, fissures, crusting, scaling in the areola area, itching, soreness, or redness, monitoring after surgical interventions on the breast, and dispensary observation of patients in the high-risk group for breast cancer (for example, due to hereditary predisposition or hormone-dependent diseases).
How to prepare for the test?
Preparation for cytology is quite simple but is important for the reliability of the result. If the woman is of reproductive age, the optimal time for the test is considered to be the 7-10 day of the menstrual cycle, when the hormonal background is most stable. It is advisable to:
• Avoid saunas, steam rooms, and hot baths.
• Do not use cosmetic products on the breast area (including creams and deodorants).
• Avoid active stimulation of the breast (e.g., during massage).
• Limit alcohol and heavy food consumption.
Wear clean cotton underwear on the day of the procedure. The intake of hormonal drugs, anticoagulants, vitamin E and some other agents may be temporarily discontinued upon the physician's recommendation. If there are results from previous analyses (ultrasound, mammography, biopsy)—it is best to bring them along. It is also important to inform the physician about chronic diseases, pregnancy, medication intake, and any complaints, even if they seem insignificant.
How is the material collected?
If nipple discharge is present, the physician gently collects it with a sterile swab or glass slide after preliminary antiseptic treatment of the nipple. The collected material is then applied to a slide and sent to the laboratory. If there is no discharge, but pathology is suspected, a puncture technique is used: fine-needle aspiration biopsy (FNAB). Cells are extracted from the suspicious lesion using a fine needle under palpation or ultrasound guidance. In the case of deeply located or dense areas, a core needle biopsy may be used, which yields a more abundant sample, thereby increasing the informativeness of the examination. After the puncture, the puncture site is treated, a sterile dressing is applied, and the patient is advised to apply cold compresses to reduce possible swelling.
Rehabilitation
Cytology is usually well tolerated. However, after a puncture, the following may be observed: slight soreness or a feeling of heaviness, swelling, hematoma at the puncture site, and minor discomfort when moving the arm. During the first 24 hours, it is advisable to avoid physical exertion, heat procedures, and wetting the puncture area. If necessary, a painkiller may be taken, excluding medications based on acetylsalicylic acid (aspirin), to avoid provoking increased bleeding. If severe pain, fever, purulent discharge, or other alarming symptoms appear, it is imperative to consult a physician.
Question and Answer
1) How long does the breast cytology test take?
The results are usually ready in 3–5 business days. With an urgent request, it is faster, within 1–2 days. If confirmatory diagnostics are necessary, for example, immunohistochemistry, the time frame increases to 7–10 days. The time to receive the report is affected not only by the type of examination but also by laboratory workload, case complexity, and sample quality.
2) What diseases does cytology detect?
Cytology provides valuable information in the following conditions:
• Inflammatory processes: mastitis, lactostasis, abscess, tuberculosis of the breast.
• Hormonal dysfunctions: hyperprolactinemia, galactorrhea, ectopic lactation.
• Benign neoplasms: fibroadenomas, cysts, intraductal papillomas.
• Precancerous conditions: atypical ductal and lobular hyperplasia, lobular neoplasia.
• Malignant tumors: ductal, lobular, medullary, inflammatory carcinoma, etc.
The method can also indicate the presence of suspicious cells that require more detailed study. This is especially important in cases of asymptomatic disease or equivocal results from other tests.
3) What does cytology show in cancer?
In a sample suspicious of oncopathology, the laboratory physician may detect:
• Atypical cells with enlarged nuclei.
• Disruptions in the structure of the cytoplasm and nuclear membrane.
• Cell polymorphism (variety of shapes and sizes).
• Signs of infiltrative growth.
• High mitotic activity (cell division).
Cytology does not always provide a definitive diagnosis, but in most cases, it allows for timely suspicion of cancer and referral of the patient for further investigation—histology, CT, MRI, or surgical biopsy. The sensitivity of the method for oncological diseases is 85–98%, and the specificity is up to 95%.
Conclusions: This is a reasonably safe examination. It effectively detects early forms of breast oncology and other pathologies. There is no need to fear it or refuse it if the physician suggests it.
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