Cytological diagnosis of mastitis with emphasis on granulomatous mastitis

Objective: The objective of the study is to evaluate the efficacy of fine needle aspiration cytology in the diagnosis of mastitis and estimate the frequency of lesions diagnosed as tuberculous mastitis solely on FNAC. Methods: A total of 506 randomly selected cases of breast lumps over a retrospective period of 5 years were evaluated clinically and subjected to FNAC. The clinical, cytological, and histopathological data of these patients were studied. The smears were stained with H&E, Papanicolaou, and Giemsa. Data was collected from the cytology section of the Pathology Department and smears retrieved were reviewed and differentiated as acute, granulomatous or tuberculous mastitis. Histopathological confirmation was done wherever possible. Results: Out of 506 cases, inflammatory lesion of breast was detected in 30 cases. The most commonly encountered lesions were acute mastitis or abscess (46%), followed by granulomatous mastitis (36%), followed by tuberculous mastitis (10%), and 6% of acute on chronic mastitis. Histopathological follow up was available for 2 patients. Conclusion: It is a well-established fact that FNAC helps confirm tuberculosis in the presence of necrosis. From the study it can be concluded that FNAC is an efficient, minimally invasive and cost-effective method in the diagnosis of acute and granulomatous mastitis. FNAC prevents delay in initiation of therapy and complications of the disease. Our study has shown us that careful screening of FNAC smears for the presence of necrosis will aid in the confirmatory diagnosis of tuberculosis.