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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 February;12(1):47-52
Gross cystic disease. Clinical evaluation of cationic content
Lazzaretti M. G., Castellani Tarabini C., Zenezini Chiozzi A., Piccagli I., Bernardelli D., Gavioli M., Rosi A., Tamborrino E.
Background. Many authors have shown the existence of two different types of breast cysts: the apocrine type characterized by a low Na/K ratio and the flattened type with a cationic ratio resembling that of plasma.
Methods. In order to evaluate our own patient population, we have collected 162 cyst fluid samples from 86 patients, aged 26-70 years (mean age: 45.98). Menopausal status, menstrual cycle phase, cyst diametre and site, cytological characterization of apocrine metaplasia, recurrence of a cystic lesion and time elapsed since the first observation, sequential changes in cationic ratio have been evaluated.
Results. Fourtysix patients had low Na/K ratios (< 3) and 40 > 3. A single cyst was present in 42 patients, while in 51.2% of cases multiple cysts were present simultaneously (24 patients had more than 4 cysts). In 34 patients cysts recurred after a mean interval of 17.2 months (range: 1-52). High ratio patients more frequently showed a change in cationic ratio. The two groups of patients identified by Na/K ratio, didn't differ significantly as to age, menopausal status, menstrual cycle phase, apocrine metaplasia, mean diametre of the cyst, incidence of recurrence, time elapsed from the first aspiration and recurrence and number of cysts simultaneously present. Recurring patients were similar to the others as to chosen parametres, except for apocrine metaplasia (marginally significant) and number of cysts aspirated.
Conclusions. The limited number of patients and the short period of follow-up (< 3 years) prevent sound conclusions as to cancer risk and more aggressive GCD, but we think Na/K ratio is too simple a marker of disease to be dismissed without a more prolonged and accurate follow-up.