Cell cannibalism: a diagnostic and prognostic marker of breast cancer


  • Mir Mohsin Department of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, India
  • Haroon Rashid Zargar Department of Plastic and Reconstructive Surgery, SKIMS, Srinagar, Jammu and Kashmir, India
  • Mohammad Amanullah Khan Department of Surgery, JNMCH, Aligarh, Uttar Pradesh, India
  • Rana Sherwani Department of Pathology, JNMCH, Aligarh, Uttar Pradesh, India




Breast cancer, Cell cannibalism, Cytophagocytosis, FNAC, Prognostic factor


Background: Cell cannibalism (cytophagocytosis) is defined as a tumor cell within a tumor cell, such that smaller tumor cells are found in the cytoplasm of larger tumor cells with crescent shaped nuclei. Aims and Objectives were to study the cytomorphological characters of cell cannibalism in primary and metastatic breast cancer, to correlate the histologic type and grade of tumors with positive rate of cannibalism and to study the role of Cannibalism as an independent prognostic factor in breast cancer.

Methods: The study was conducted during the period of July 2003 to June 2005 in the Department of Surgery and Pathology, JNMCH, Aligarh. A total of 42 cases were included in the study. A minimum of 3 FNAC smears per case were assessed for cytophagocytosis. Presence of metastasis was also noted to establish the cytological grade and aggressiveness of the tumor.

Results: Out of 42 cases, significant cannibalistic activity was noted in 30 (71.42%) cases. All grade III (33.4%) breast tumors were found positive for cytophagocytosis (4.28/smear), while the rate was much lower (2.33/smear) in grade II and (1.63/smear) in grade I tumors. LN metastasis was confirmed by histopathological examination in all high grade tumors showing significant cannibalistic activity.

Conclusions: Cannibalism in breast carcinoma is an indicator of both the anaplastic grade and invasiveness. The rate of cytophagocytosis may have a prognostic significance.


Kojima S, Sekine H, Fukui I, Ohshima H. Clinical significance of “cannibalism” in urinary cytology of bladder cancer. Acta Cytol. 1998;42(6):1365-9.

Bauchwitz M. The bird’s-eye cell: cannibalism or abnormal division of tumor cells. Acta Cytol. 1981;25:92.

Gupta K, Dey P. Cell cannibalism: diagnostic marker of malignancy. Diagn Cytopathol. 2003;28(2):86-7.

Fais S. Cannibalism: a way to feed on metastatic tumors. Cancer Lett. 2007;258(2):155-64.

Uei Y, Watanabe Y, Hirota T, Yamamoto H, Watanabe H. Cytologic diagnosis of breast carcinoma with nipple discharge: special significance of the spherical cell cluster. Acta Cytol. 1980;24(6):522-8.

Guo KJ, Yamaguchi K, Enjoji M. Undifferentiated carcinoma of the gallbladder a clinicopathologic, histochemical, and immunohistochemical study of 21 patients with a poor prognosis. Cancer. 1988;61(9):1872-9.

Craig ID, Desrosiers P, Lefcoe MS. Giant-cell carcinoma of the lung: a cytologic study. Acta Cytol. 1983;27(3):293-8.

Kumar PV, Hosseinzadeh M, Bedayat GR. Cytologic findings of medulloblastoma in crush smears. Acta Cytol. 2001;45(4):542-6.

Desimone PA, East R, Powell RD. Phagocytic tumor cell activity in oat cell carcinoma of the lung. Hum Pathol. 1980;11(5):535-9.

Sharma N, Dey P. Cell cannibalism and cancer. Diagn Cytopathol. 2011;39(3):229-33.

Mohan A, Singh S, Kaur S, Agarwal A, Solanki R, Thakral RK, et al. Cell cannibalism as an indicator of anaplasia and tumor aggresiveness in carcinoma breast. J Adv Res Biol Sci. 2013;5(3):286-9.

Caruso RA, Muda AO, Bersiga A, Rigoli L, Inferrera C. Morphological evidence of neutrophil-tumor cell phagocytosis (cannibalism) in human gastric adenocarcinomas. Ultrastruct Pathol. 2002;26(5):315-21.

Bansal C, Tiwari V, Singh U, Srivastava A, Misra J. Cell cannibalism: a cytological study in effusion samples. J Cytol. 2011;28(2):57-60.

Abodief WT, Dey P, Al-Hattab O. Cell cannibalism in ductal carcinoma of breast. Cytopathol Off J Br Soc Clin Cytol. 2006;17(5):304-5.

Jose D, Mane DR, Datar U, Muttagi S, Hallikerimath S, Kale AD. Evaluation of cannibalistic cells: a novel entity in prediction of aggressive nature of oral squamous cell carcinoma. Acta Odontol Scand. 2014;72(6):418-23.






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