Cytological Evaluation of Fine Needle Aspiration of Breast Lesions Using IAC Yokohama Classification System for Reporting Breast Cytopathology

Abstract

Introduction: Breast cancer is rapidly emerging as the leading cause of cancer in Indian women. Cytopathology and histopathology services are required to tackle this growing burden. The use of International Academy of Cytology (IAC) Yokohama Reporting System of breast cytology by classifying them into five categories insufficient, benign, atypical, suspicious and malignant. (IAC) Yokohama Reporting System offers structured protocols, are expected to improve breast cytopathology reporting. Objective : The main objectives of our study were to classify breast fine needle aspirates according to the IAC Yokohama system and assess the risk of malignancy, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. Methodology: All breast FNAs done in the above period were retrieved and classified into five categories according to the Yokohama system. Histopathological diagnosis was also retrieved wherever available. Results: The new “International Academy of Cytology (IAC) Yokohama system” was used to categorize 205 patients into five categories based on the cytologic diagnosis. That C1: insucient material (7.8%), C2: benign (64.3%), C3: atypical (7.3%), C4: suspicious of malignancy (7.8%), and C5: malignant (12.6%). Risk of malignancy (ROM) was calculated which was 100% in Yokohama category I, IV and V. In category II ROM was 00% and in category III ROM was 55.5%. FNAC correlation with histopathology was significant (P Value=<0.01 & Chi square value 40.7). Conclusion: The IAC Yokohama system is an excellent system for accurately diagnosing breast fine needle aspirate. Keywords: Histopathology, International Academy of Cytology Yokohama System, Fine­ Needle Aspiration Biopsy Cytopathology