Introduction: BI-RADS in mammography screening is the guide to give a standardized terminology in mammary images. The BI-RADS 3 (uncertain cases) protocol requires anew mammography after six months. This matter of time usually generates much concern and anxiety in patients and in the Radiologists. The aim of this study is to show that using the test of micronuclei (MN) in exfoliated mucosa buccal cells a very early diagnosis is achieved.
Material and methods: We performed an extensive search on Pub Med for "micronuclei in exfoliated buccal cells in breast cancer "and micronuclei in breast cancer". We looked for the keywords in free text and with the cross-referencing method application. We experimentally got samples of buccal mucosa cells from twenty women BI-RADS 3 and twenty women BI-RADS 2. We fixed the samples with Papanicolaou staining. We registered the percentage of the cells containing MN in a total of 500 cells for each sample. The U Mann Whitney Calculator is the test for the statistical analysis of the results.
Results: Many studies showed that breast cancer produced MN both in exfoliated cells and in needle aspiration. Their score's count was higher than compared to benign cases, while in the peripheral blood lymphocytes, the results for the MN test were not reproducible. In our preliminary study, the mean percentages of MN in buccal mucosa cells of BI-RADS 3 vs BI-RADS2 didn't show a significant difference: p = 0.05. Two samples of BI-RADS 3 group had a much higher count of MN with a mean of 2.91 ±0.09, 2.88 ±0.08, respectively. This case required biopsy despite the in most of the cases of BI-RADS 3 investigated, the MN test confirmed their benignity.
Discussion: In literature, several studies have shown that the genetic damage in breast cancer cells results in MN increased production. Our research showed that in some cases of BI-RADS 3 there was a great increase in MN level. This fact happens in the patients who have taken oestrogens for many years. This therapy is definitely a strong risk factor for breast cancer development because the excesses of any type of hormones interacts with normal breast cell differentiation process. This BI-RADS 3 situation needs further investigation.
Conclusion: It's interesting to apply the MN scoring in BI-RADS3 because in some cases this test can expect a cancer diagnosis by at least six months' time because, in the other cases, test result can reassure both patient and Radiologists who will wait for the next following checkup with no anxiety.
Keywords: BIRADS; breast cancer micronucleus..