The legitimacy of the atypical (C3) breast cytology category

Zardawi, Ibrahim M.; Weigner, Julie

doi:10.4038/jdp.v11i1.7689

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…Among the C3 cases, two cases (3.3%) unveiled benign lesions on histopathology. Zardawi et al's[14] study similarly found benign proliferative lesions and low-grade cancers within the C3 category, mirroring our findings. In the C4 category, five cases (8.3%) indicated malignancy on histopathology.…”

supporting

confidence: 90%

Diagnostic Utility of Fine-Needle Aspiration Cytology (FNAC) and Frozen Section Against Histopathology in Evaluating Benign and Malignant Breast Lesions

Sharma,

Ojha,

2024

Cureus

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Introduction: Breast lesions, particularly lumps, pose concerns for females, varying between benign and malignant conditions. Accurate differentiation solely through clinical assessment is challenging, necessitating a definitive diagnostic strategy. Fine-needle aspiration cytology (FNAC) is integral in the "triple approach" to breast evaluation, offering simplicity, reliability, and cost-effectiveness. However, FNAC has limitations, occasionally failing to yield definitive diagnoses due to inherent constraints. Contrarily, frozen-section analysis, a long-standing intraoperative diagnostic method, plays a crucial role in swift diagnosis during surgeries. Despite technological advancements, frozen sections serve specific diagnostic purposes, confirming carcinoma when FNAC is inconclusive and evaluating resected margins. However, freezing artifacts may affect tissue assessment, emphasizing the continued reliance on histopathology for guiding treatment decisions. Objectives: This study was conducted at KVG Medical College and Hospital, Sullia, Karnataka, India. It aimed to analyze the morphological characteristics of benign and malignant breast lesions using FNAC, frozen section, and histopathology and evaluate the sensitivity, specificity, and predictive values of FNAC and frozen section against histopathology as the reference standard. Methods: A cross-sectional investigation was carried out at a tertiary care hospital's Department of Pathology, on 60 female patients who presented with palpable breast masses over a span of two and a half years. FNAC was conducted, and the observations were classified into five categories as per the International Academy of Cytology guidelines. In addition, intraoperative frozen-section analysis was undertaken. A comparative analysis was conducted between the FNAC and intraoperative frozen-section findings, juxtaposed with the subsequent histopathological diagnoses. Results: FNAC revealed 51.7% malignant, 45% benign, and 3.3% inadequate cases; the frozen-section analysis indicated 51.6% malignant, 45% benign, and 3.3% deferred cases; histopathology showed 53.3% malignant, 45% benign, and 1.6% borderline cases. FNAC demonstrated 93.9% sensitivity, 100% specificity, 100% positive predictive value (PPV), 93.1% negative predictive value (NPV), and 96.7% accuracy. The frozen-section analysis exhibited 96.9% sensitivity, 100% specificity, 100% PPV, 96.4% NPV, and 98.3% accuracy. Conclusion: Intraoperative frozen-section analysis displays superior diagnostic utility compared to preoperative FNAC. However, histopathology remains the definitive gold standard. Integrating all three diagnostic modalities is crucial for precise diagnosis and effective patient management.

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confidence: 90%

Diagnostic Utility of Fine-Needle Aspiration Cytology (FNAC) and Frozen Section Against Histopathology in Evaluating Benign and Malignant Breast Lesions

Sharma,

Ojha,

2024

Cureus

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“…ILC also featured in the C3 group, mainly because of paucicellularity of the sample and the coexistence of benign epithelium. [12] In C4 category, 18 cases were available Histologically. Of the 18 cases 15 cases were diagnosed as invasive ductal carcinoma, 1 case as invasive lobular carcinoma, 1 case as carcinoma with neuroendocrine feature and 1 case as cystic papillary neoplasm.…”

Section: A-56mentioning

confidence: 99%

A Study of Fine Needle Aspiration Cytology of Breast Lump With The Use of National Health Service Breast Screening Program (NHSBSP) - Study Of 500 Cases

Shahu,

Gamit,

Sheth

et al. 2022

Ann of Pathol and Lab Med

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Background: FNAC is rapid, simple, safe, cost effective and good screening procedure with high sensitivity and specificity. Clinically, the diseases of breast mainly present as palpable breast lump, pain and nipple discharge. Most of the breast lumps are benign but pose a significant anxiety to the patient, which can be allayed by giving assurance that, usually it is benign. So it is necessary to distinguish benign from malignant conditions Methods: The present study on was carried out during June 2017 to May 2019. We categorized the patients into C1 (Inadequate), C2 (Benign), C3 (Atypia, probably benign), C4 (Suspicious of malignancy) and C5 (Malignant) category according to NHSBSP and correlated histopathologically whenever available. Result: Total 500 cases examined. Majority of the cases were in the 3rd decade of the life. Benign category comprised of 368 cases (73.6%), followed by malignant disease 61 (12.2%). Fibroadenoma was most common comprising of 230 cases (62.3%) among benign cases. Out of 230 cases of Fibroadenoma, most (89) cases were in 21-30 years age group, followed by 11-20 years age group. Breast carcinoma was most common (31.1%) in 41-50 years age group and 61-70 (27.9%) years age group followed by 51-60 (19.7%) years age group. Conclusion: FNAC of breast lesions is advantageous for both clinicians and patients because of its immediate results, economy, and accuracy. FNAC has got significant diagnostic value in differentiating benign from malignant lesions providing us valuable information for planning of subsequent therapeutic management and avoiding unwanted surgeries.

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IAC standardized reporting of breast fine-needle aspiration cytology, Yokohama 2016: A critical appraisal over a 2 year period

Chauhan

Pujani

Agarwal

et al. 2019

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The legitimacy of the atypical (C3) breast cytology category

Cited by 3 publications

References 36 publications

Diagnostic Utility of Fine-Needle Aspiration Cytology (FNAC) and Frozen Section Against Histopathology in Evaluating Benign and Malignant Breast Lesions

Diagnostic Utility of Fine-Needle Aspiration Cytology (FNAC) and Frozen Section Against Histopathology in Evaluating Benign and Malignant Breast Lesions

A Study of Fine Needle Aspiration Cytology of Breast Lump With The Use of National Health Service Breast Screening Program (NHSBSP) - Study Of 500 Cases

IAC standardized reporting of breast fine-needle aspiration cytology, Yokohama 2016: A critical appraisal over a 2 year period

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