Study of Breast Cytology Smears Using The International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology
DOI:
https://doi.org/10.37506/9gegg469Keywords:
Yokohama system; Breast cytopathology; Fine needle aspiration cytology; Risk of malignancy ; carcinomaAbstract
Background: Breast cancer is a major global health burden, especially in low- and middle-income regions where fine-needle aspiration cytology (FNAC/FINE NEEDLE ASPIRATION CYTOLOGY) remains a widely used diagnostic tool. The International Academy of Cytology (IAC) Yokohama System provides a standardized, evidence-based framework to improve diagnostic consistency in breast cytology.
Objective: To evaluate the diagnostic utility, accuracy, and risk of malignancy (ROM) of the IAC Yokohama System in categorizing breast FNAC/FINE NEEDLE ASPIRATION CYTOLOGY samples in a tertiary care setting.
Methods: A prospective study of 128 FNAC/FINE NEEDLE ASPIRATION CYTOLOGY samples from 120 patients was conducted and categorized according to the IAC Yokohama System. Cyto-histopathological correlation was available for 26 cases. Diagnostic performance indices were calculated using MedCalc.
Results: The distribution of cases was: Category 2 (Benign), 78.1%; Category 3 (Atypical), 3.3%; Category 4 (Suspicious), 3.3%; and Category 5 (Malignant), 15.6%. No Category 1 cases were recorded. Fibroadenoma was the most common benign lesion (38.2%). Overall cyto-histopathological concordance was 84.6%. ROM was 0% (Category 2), 66.7% (Category 3), and 100% for Categories 4 and 5. Diagnostic performance showed sensitivity 40.0%, specificity 95.2%, positive predictive value 66.7%, negative predictive value 87.0%, and overall accuracy 84.6%.
Conclusion: The IAC Yokohama System enhances the diagnostic reliability of FNAC/FINE NEEDLE ASPIRATION CYTOLOGY for distinguishing benign and malignant breast lesions. However, indeterminate categories (3 and 4) continue to require histopathological confirmation. The system offers significant value in resource-constrained settings, though larger multicentric studies are warranted to refine ROM estimates and strengthen generalizability.
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