Diagnostic accuracy of fine needle aspiration cytology for breast lump by yokohama system for reporting and its correlation with histomorphology
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Abstract
Background: The International Academy of Cytology Yokohama System has created a standardized method of describing breast cytology by grouping them into 5 categories: inadequate, benign, atypical, suspicious, and malignant. To validate the likelihood of cancer in the various categories, several investigations have been undertaken at various institutions as a mandate. Aim: The main objective of the research is to identify the accuracy of fine needle aspiration cytology for breast lumps by the Yokohama system for reporting and its correlation with histopathology. Methodology: The present study was a retrospective research performs over 8 month. FANC’s for breast lumps performed by the Yokohama system. Whenever accessible, histopathological diagnoses were also retrieved. Statistical Analysis Used: Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were estimated using a histological diagnosis as the gold standard concerning each of the five categories. Outcomes: Out of 200 cases 106 had histopathological concordance. Five categories - insufficient, benign, atypical, suspicious, and malignant of the IAC Yokohama system were 1.00%, 62.50%, 4.50%, 1.50%, and 30.50% ,Category1(1%), category2 (62.5%), category3 (4.5%), category4(1.5%),category5 (30.5%). When malignant, suspicious, and unusual cases were taken into account as positive test findings, the highest level of sensitivity (90.60%) was attained. The maximum specificity (100%) was seen when only malignant patients were taken into account as positive test findings, but the highest diagnostic accuracy (96.22%) was shown when the malignant and suspect categories were taken into account as positive test results. Conclusion: FNAC using the Yokohama system for reporting is an accurate diagnostic tool for breast lumps. The system provides a standardized framework for reporting FNAC findings, and studies have reported high sensitivity and specificity rates for diagnosing breast lumps using FNAC. Therefore, FNAC can be used in conjunction with histomorphology to ensure accurate diagnosis and appropriate management of breast lumps.
1. Yong WS, Chia KH, Poh WT and Wong CY. A comparison of trust biopsy with fine needle aspiration cytology in the diagnosis of breast cancer. Singapore Med J. 1999; 40(9): 587-589.
2. Gupta S. Breast cancer: Indian experience, data, and evidence. South Asian J Cancer. 2016;5:85-6.
3. Rahman MZ, Islam S. Fine Needle Aspiration Cytology of Palpable Breast Lump: A Study of 1778 Cases. Surgery S12:001. doi 10.4172/2161- 1076.S12-001.
4. Obaseki DE, Olu-Edo AN, Ogunbiyi JO. Diagnostic accuracy of fine needle aspiration cytology of palpable breast masses in Benin City, Nigeria. West Afr J Med. 2010; 29(4):259-262. PubMed.
5. Jindal U, Singh K, Kochhar A. Fine Needle Aspiration Cytology of Breast Lumps with Histopathological Correlation: A Four Year and eight-month study from rural India. Internet J Pathol. 2012; 13(3).
6. Wang M, He X, Chang Y, Sun G, Thabane L.Asensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in the evaluation of suspicious breast lesions: A systematic review and meta-analysis. Breast 2017;31:157-6
7. Hoda RS, Brachtel EF. International Academy of Cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology: A review of predictive values and risks of malignancy. Acta Cytol 2019;63:292-301.
8. Wong S, Rickard M, Earls P, Arnold L, Bako B, Field AS. The international academy of Cytology Yokohama system for reporting breast fine needle aspiration biopsy cytopathology: A single institutional retrospective study of the application of the system categories and the impact of rapid onsite evaluation. Acta Cytol 2019;63:280-91.
9. Montezuma D, Malheiros D, Schmitt FC. Breast fine needle aspiration biopsy cytology using the newly proposed IAC Yokohama system for reporting breast cytopathology: The experience of a single institution. Acta Cytol 2019;63:274-9
10. Field AS, Raymond WA, Rickard M, Arnold L, Brachtel EF, Chaiwun B, et al. The international academy of Cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Acta Cytol 2019;63:257-73
11. Wai CJ, Al-Mubarak G, Homer MJ, Goldkamp A, Samenfeld-Specht M, Lee Y, et al. A modified triple test for palpable breast masses: The value of ultrasound and core needle biopsy. Ann Surg Oncol 2013;20:850-5.
12. Bisht DS, Sharma H, Sharma DJ, Upadhyay V. To compare the diagnostic accuracy of FNAC with histopathology in benign and malignant breast lumps. Indian J Pathol Oncol 2022;9(2):107-111
13. Ahuja S, Malviya A. Categorization of breast fine needle aspirates using the international academy of Cytology Yokohama system along with the assessment of the risk of malignancy and diagnostic accuracy in a tertiary care center. J Cytol 2021;38:158-63
14. Kamatar P, Athanikar V, Dinesh US. Breast fine needle aspiration biopsy cytology reporting using international academy of Cytology Yokohama system-two year retrospective study in the tertiary care center in Southern India. National Journal of Laboratory Medicine 2019;8:PO01-3.
15. De Rosa F, Migliatico I, Vigliar E, Salatiello M, Pisapia P, Iaccarino A, et al. The continuing role of breast fine-needle aspiration biopsy after the introduction of the IAC Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Diagn Cytopathol 2020;48:1244-53.
16. Apuroopa M, Chakravarthy VK, Rao DR. Application of Yokohama system for reporting breast fine needle aspiration cytology in correlation with histopathological and radiological findings. Annals Pathol Lab Med 2020;7:A210-5.
17. McHugh KE, Bird P, Sturgis CD. Concordance of breast fine needle aspiration cytology interpretation with subsequent surgical pathology: An 18-year review from a single sub-Saharan African institution. Cytopathology 2019;30:519-25
18. Wong S, Rickard M, Earls P, Arnold L, Bako B, Field AS. The international academy of Cytology Yokohama system for reporting breast fine needle aspiration biopsy cytopathology: A single institutional retrospective study of the application of the system categories and the impact of rapid onsite evaluation. Acta Cytol 2019;63:280-91.
19. Agarwal A, Singh D, Mehan A, Paul P, Puri N, Gupta P, et al. Accuracy of the International Academy of Cytology Yokohama system of breast cytology reporting for fine needle aspiration biopsy of the breast in a dedicated breast care setting. Diagn Cytopathol 2021;49:195-202.
20. Montezuma D, Malheiros D, Schmitt FC. Breast fine needle aspiration biopsy cytology using the newly proposed IAC Yokohama system for reporting breast cytopathology: The experience of a single institution. Acta Cytol 2019;63:274-9.
21. Chan et al. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants. BMC Cancer (2017) 17:274
22. Gardas V. Cytological study of breast lumps with histopathological correlation. Indian J Basic Appl Med Res. 2018;7:185–92.
2. Gupta S. Breast cancer: Indian experience, data, and evidence. South Asian J Cancer. 2016;5:85-6.
3. Rahman MZ, Islam S. Fine Needle Aspiration Cytology of Palpable Breast Lump: A Study of 1778 Cases. Surgery S12:001. doi 10.4172/2161- 1076.S12-001.
4. Obaseki DE, Olu-Edo AN, Ogunbiyi JO. Diagnostic accuracy of fine needle aspiration cytology of palpable breast masses in Benin City, Nigeria. West Afr J Med. 2010; 29(4):259-262. PubMed.
5. Jindal U, Singh K, Kochhar A. Fine Needle Aspiration Cytology of Breast Lumps with Histopathological Correlation: A Four Year and eight-month study from rural India. Internet J Pathol. 2012; 13(3).
6. Wang M, He X, Chang Y, Sun G, Thabane L.Asensitivity and specificity comparison of fine needle aspiration cytology and core needle biopsy in the evaluation of suspicious breast lesions: A systematic review and meta-analysis. Breast 2017;31:157-6
7. Hoda RS, Brachtel EF. International Academy of Cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology: A review of predictive values and risks of malignancy. Acta Cytol 2019;63:292-301.
8. Wong S, Rickard M, Earls P, Arnold L, Bako B, Field AS. The international academy of Cytology Yokohama system for reporting breast fine needle aspiration biopsy cytopathology: A single institutional retrospective study of the application of the system categories and the impact of rapid onsite evaluation. Acta Cytol 2019;63:280-91.
9. Montezuma D, Malheiros D, Schmitt FC. Breast fine needle aspiration biopsy cytology using the newly proposed IAC Yokohama system for reporting breast cytopathology: The experience of a single institution. Acta Cytol 2019;63:274-9
10. Field AS, Raymond WA, Rickard M, Arnold L, Brachtel EF, Chaiwun B, et al. The international academy of Cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Acta Cytol 2019;63:257-73
11. Wai CJ, Al-Mubarak G, Homer MJ, Goldkamp A, Samenfeld-Specht M, Lee Y, et al. A modified triple test for palpable breast masses: The value of ultrasound and core needle biopsy. Ann Surg Oncol 2013;20:850-5.
12. Bisht DS, Sharma H, Sharma DJ, Upadhyay V. To compare the diagnostic accuracy of FNAC with histopathology in benign and malignant breast lumps. Indian J Pathol Oncol 2022;9(2):107-111
13. Ahuja S, Malviya A. Categorization of breast fine needle aspirates using the international academy of Cytology Yokohama system along with the assessment of the risk of malignancy and diagnostic accuracy in a tertiary care center. J Cytol 2021;38:158-63
14. Kamatar P, Athanikar V, Dinesh US. Breast fine needle aspiration biopsy cytology reporting using international academy of Cytology Yokohama system-two year retrospective study in the tertiary care center in Southern India. National Journal of Laboratory Medicine 2019;8:PO01-3.
15. De Rosa F, Migliatico I, Vigliar E, Salatiello M, Pisapia P, Iaccarino A, et al. The continuing role of breast fine-needle aspiration biopsy after the introduction of the IAC Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Diagn Cytopathol 2020;48:1244-53.
16. Apuroopa M, Chakravarthy VK, Rao DR. Application of Yokohama system for reporting breast fine needle aspiration cytology in correlation with histopathological and radiological findings. Annals Pathol Lab Med 2020;7:A210-5.
17. McHugh KE, Bird P, Sturgis CD. Concordance of breast fine needle aspiration cytology interpretation with subsequent surgical pathology: An 18-year review from a single sub-Saharan African institution. Cytopathology 2019;30:519-25
18. Wong S, Rickard M, Earls P, Arnold L, Bako B, Field AS. The international academy of Cytology Yokohama system for reporting breast fine needle aspiration biopsy cytopathology: A single institutional retrospective study of the application of the system categories and the impact of rapid onsite evaluation. Acta Cytol 2019;63:280-91.
19. Agarwal A, Singh D, Mehan A, Paul P, Puri N, Gupta P, et al. Accuracy of the International Academy of Cytology Yokohama system of breast cytology reporting for fine needle aspiration biopsy of the breast in a dedicated breast care setting. Diagn Cytopathol 2021;49:195-202.
20. Montezuma D, Malheiros D, Schmitt FC. Breast fine needle aspiration biopsy cytology using the newly proposed IAC Yokohama system for reporting breast cytopathology: The experience of a single institution. Acta Cytol 2019;63:274-9.
21. Chan et al. Evaluation of the association between quantitative mammographic density and breast cancer occurred in different quadrants. BMC Cancer (2017) 17:274
22. Gardas V. Cytological study of breast lumps with histopathological correlation. Indian J Basic Appl Med Res. 2018;7:185–92.
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| Issue | Vol 16 No 1 (2024) | |
| Section | Original Articles | |
| Keywords | ||
| Pathology histomorphology diagnosis | ||
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How to Cite
1.
Taur N, Soni R, Deshmukh A, Chaukade S. Diagnostic accuracy of fine needle aspiration cytology for breast lump by yokohama system for reporting and its correlation with histomorphology. Basic Clin Cancer Res. 2025;16(1):1-9.
