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A retrospective cytology-to-histopathology study analyzed clinical and pathology records to define cytomorphological features that distinguish benign from malignant disease. Benign lesions showed cohesive clusters and clear backgrounds, while atypical or malignant cases showed loss of myoepithelial cells, non-cohesive clusters, and necrotic/dirty backgrounds. 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Udupa, Mary Mathew, Ranjini Kudva, Brij Mohan Kumar Singh  \nDepartment of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India  \nAbstract  \nBackground and Objectives: Papillary lesions of the breast represent a diverse group of neoplasms with varying biological behavior, ranging from benign to malignant. Accurate diagnosis is critical for appropriate clinical management. This study aims to analyze the cytopathological features of papillary breast lesions to improve diagnostic accuracy. Materials and Methods: A retrospective study was performed on cases of papillary neoplasm of the breast diagnosed on cytology followed by histopathology during the study period, after procuring institutional ethical committee clearance. The clinical, pathologic, and follow-up details were retrieved from the hospital records and the pathology database and were analyzed. Results: The study identified distinct benign and malignant papillary lesions, including intraductal papilloma, papillary ductal carcinoma in situ, encapsulated papillary carcinoma, and solid papillary carcinoma. The mean age of the study participants was 51.15 years. Benign neoplasms showed cohesive clusters and a clear background on cytology, while cases with atypical or malignant features demonstrated loss of myoepithelial cells, non-cohesive clusters, and necrotic/dirty background. Conclusion: Papillary breast lesions encompass a wide spectrum of pathology, necessitating precise cytologic and histopathologic evaluation. The presence or absence of myoepithelial markers aids in differentiating benign from malignant lesions. Identification of cytologic features of benign and malignant neoplasms can improve diagnostic accuracy, enhance patient management, and ensure timely intervention for malignant cases.  \nKeywords: Breast, cytopathology, papilloma  \nIntroductIon  \nPapillary lesions of the breast represent a heterogeneous group of entities ranging from benign intraductalpapilloma to papillary ductal carcinoma in situ and malignant papillary carcinomas. Although these lesions constitute a small percentage of breast pathologies, less than 10% of benign breast neoplasms and approximately 1%–2% of breast carcinomas, their diagnosis remains challenging due to overlapping cytological, radiological, and histological features.[1] Accurate diagnosis of these lesions is crucial because their management and prognosis differ significantly depending on the degree of atypia and malignancy.  \nFine-needle aspiration cytology (FNAC) is a widely used, minimally invasive diagnostic technique for evaluating breast lesions. However, its role in diagnosing papillary  \n\n| Access this article online |  |\n| --- | --- |\n| Quick Response Code:\u003Cbr>| Website:\u003Cbr>[https://journals.lww.com/jocy](https://journals.lww.com/jocy) |\n|  | DOI:\u003Cbr>10.4103/joc.joc_49_25 |\n\nlesions remains debatable, particularly in distinguishing benign from malignant cases. The morphological overlap between these lesions, such as the presence of papillary fragments, high cellularity, and cohesive clusters of cells, often leads to diagnostic pitfalls.[1,2] Furthermore, the absence of traditional malignant features, such as necrosis or loss of myoepithelial cells, in low-grade papillary carcinomas complicates cytologic evaluation.[2]  \nAddress for correspondence: Dr. Brij Mohan Kumar Singh, Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal-576104, Karnataka, India.  \nE-mail: [brij.singh@manipal.edu](brij.singh@manipal.edu)  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License (CC BY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or ","cbCaiuRJzM23SYgq","https://ap.wps.com/l/cbCaiuRJzM23SYgq","pdf",3556289,"English","# Background and Objectives\n# Materials and Methods\n# Results\n# Conclusion\n# Introduction\n# Fine-Needle Aspiration Cytology (FNAC)\n# Cytological Parameters and Histopathologic Correlation\n# Materials and Methods","[{\"question\":\"What is the main purpose of the cytomorphological analysis in this study?\",\"answer\":\"To analyze cytopathological features of papillary breast lesions and improve diagnostic accuracy for benign versus malignant entities.\"},{\"question\":\"Which cytology findings were associated with benign papillary lesions?\",\"answer\":\"Benign neoplasms showed cohesive epithelial clusters and a clear background, including features such as myoepithelial cells.\"},{\"question\":\"What cytological features suggested atypical or malignant papillary lesions?\",\"answer\":\"Atypical or malignant cases demonstrated loss of myoepithelial cells, non-cohesive clusters, and necrotic/dirty background patterns.\"}]","A Comprehensive Cytomorphological Analysis of Papillary Neoplasms of the Breast | PDF",1790128571]