In my mother's breast there is a lump. In the FNAC report written as "breast cytology category c5 (malignant) with cytomorphological features" What does it mean?

Question

FNAC category C5 means cancer. She needs a proper evaluation by a breast surgeon, which entails a history and clinical examination with a mammography and an ultrasound if not done already. Mammography gives an idea about the whole breast and Opposite Breast. I prefer a core Biopsy, which gives an idea about the grade, type and immunohistochemistry of cancer, which is important for getting an idea about the prognosis and deciding the line of treatment. (I am not comfortable operating based on FNAC as it has false negative’s aswell as false positives) If Cancer is locally advanced or some times in large operable wanting breast conservation surgery or some early Breast cancers which are Triple negative or Her 2 +ve, then upfront chemotherapy is preferred before surgery. If locally advanced or > 5 cms then we prefer doing a pet scan or a CECT abdomen and pelvis with a bone scan to rule out spread of cancer. Surgery for the breast may be lumpectomy or a mastectomy. Axillary surgery may be sentinel node biopsy or an Axillary nodal clearance. If conservation then the reconstruction could be with oncoplasty which approximates the Breast tissue to prevent deformity (but leads to smaller breast if large lump excised and needs mammoplasty of that breast as well as reduction of Opposite Breast), or using the latest chest wall perforator flaps (new technique to avoid deformity or reduction of breast size especially after a large lumpectomy in a small Breast, which I have learnt in UK and is becoming quite popular there as the size of both breasts remains same) After the surgery, chemotherapy is given (if not given before or courses not completed) the type of chemotherapy or targeted therapy varies according to the report. All lumpectomy and mastectomy for large and node positive cancers need radiation therapy too, which is given after the chemotherapy. Also depending upon the immunohistochemistry, targeted therapy (transtuzumab) May be advised for 1 year and hormonal therapy for 5-10 years. The follow up would be with annual mammogram, clinical examination with some blood tests. If found to be metastatic then treatment would be mainly chemotherapy and hormonal therapy, with surgery for good responders or in cases of bleeding, where radiation is the other option. Feel free to contact me directly if you want to share the reports or discuss this further.

Nikhilesh Borkar · Accepted Answer

FNAC category C5 means cancer. She needs a proper evaluation by a breast surgeon, which entails a history and clinical examination with a mammography and an ultrasound if not done already. Mammography gives an idea about the whole breast and Opposite Breast. I prefer a core Biopsy, which gives an idea about the grade, type and immunohistochemistry of cancer, which is important for getting an idea about the prognosis and deciding the line of treatment. (I am not comfortable operating based on FNAC as it has false negative’s aswell as false positives) If Cancer is locally advanced or some times in large operable wanting breast conservation surgery or some early Breast cancers which are Triple negative or Her 2 +ve, then upfront chemotherapy is preferred before surgery. If locally advanced or > 5 cms then we prefer doing a pet scan or a CECT abdomen and pelvis with a bone scan to rule out spread of cancer. Surgery for the breast may be lumpectomy or a mastectomy. Axillary surgery may be sentinel node biopsy or an Axillary nodal clearance. If conservation then the reconstruction could be with oncoplasty which approximates the Breast tissue to prevent deformity (but leads to smaller breast if large lump excised and needs mammoplasty of that breast as well as reduction of Opposite Breast), or using the latest chest wall perforator flaps (new technique to avoid deformity or reduction of breast size especially after a large lumpectomy in a small Breast, which I have learnt in UK and is becoming quite popular there as the size of both breasts remains same) After the surgery, chemotherapy is given (if not given before or courses not completed) the type of chemotherapy or targeted therapy varies according to the report. All lumpectomy and mastectomy for large and node positive cancers need radiation therapy too, which is given after the chemotherapy. Also depending upon the immunohistochemistry, targeted therapy (transtuzumab) May be advised for 1 year and hormonal therapy for 5-10 years. The follow up would be with annual mammogram, clinical examination with some blood tests. If found to be metastatic then treatment would be mainly chemotherapy and hormonal therapy, with surgery for good responders or in cases of bleeding, where radiation is the other option. Feel free to contact me directly if you want to share the reports or discuss this further.

Anjanjyoti Sarma · Answer

I am afraid, but c5 malignacy means she is an unfortunate victim of the deadliest disease. It will be better to consult a breast onco surgeon at the earliest. Please remember, cancer cells grow and infiltrate in every seconds. So every second matters for treatment result. Good thing is breast cancer is treatable now a days.

Vinod Goyal · Answer

It is cancer and you should take cancero medicine course for recovery.