The Uniform Approach to Breast Fine Needle Aspiration Biopsy

Bibbo, Marluce; Abati, Andrea; Ferenczy, Alex; Robitaille, Juliette; Franco, Eduardo L.; Arseneau, Jocelyne; Richart, Ralph M.; Wright, Thomas; Elsheikh, Tarik M.; Bernacki, Edward G.; Burch, Henry B.; Burman, Kenneth D.; Reed, H. Lester; Buckner, Leigh; Raber, T.; Ownbey, James L.; Cangiarella, Joan; Verbeek, Dick; Smedts, Frank; Wijnen-Dubbers, Carolien W.; Mravunac, M.; Cajigas, Antonio; Savala, Edward; Elgert, Paul; Slamovits, Thomas L.; Suhrland, Mark J.; Bailey, Michael; Brown, Richard W.; DiTomasso, John P.; Ramzy, Ibrahim; Mody, Dina R.; Luzzatto, Rui; Boon, Mathilde E.; Ojanguren, Isabel; Castellà, Eva; Llatjós, Mariona; Ariza, Aurelio; Palacios, José J. Navas; Loggie, Brian W.; Fleming, Ronald A.; Geisinger, Kim R.; Jinza, Shin-ichirou; Iki, Masayuki; Noguchi, Sumio; Shuin, Taro; Kubota, Yoshinobu; Takano, Yasuo; Masuda, Mitsunobu; Tabbara, Sana O.; Acoury, Nahla; Sidawy, Mary K.; Centeno, Barbara A.; Szyfelbein, Wanda M.; Daniels, Gilbert H.; Vickery, Austin L.; Cagle, Philip T.; Sinha, Sanjay; Singh, Usha; Bhatia, Arati; Chao, Tsu‐Yi; Chiou, Wen-Yaw; Liang, Jia-Guang; Tsao, Tang‐Yi; Mulvany, Nicholas J.; Green, Linda K.; Griffin, Jim E.; Lee, Seung-Sook; Cho, Kyung–Ja; Saleh, Husain; Khatib, Ghanim; Jang, Ja‐June; Ham, Eui Keun; Kumar, Perikala V.; Owji, Seyyed Mohammad; Khezri, A. A.; Pohar‐Marinšek, Živa; Us‐Krašovec, Marija; Öztek, İbrahim; Baloğlu, Hüseyi̇n; Üskent, Necdet; Kartaloğlu, Zafer; Uçmaklı, Ergün; Aydilek, Recep; Dorkip, Osman; Yaylacı, Mustafa; Özel, Melih; Schechter, Clyde B.; Papadimitriou, John C.; Abruzzo, Lynne V.; Bourquin, Patricia M.; Drachenberg, Cinthia B.; Stastny, Janet F.; Harris, Alan C.; Ben‐Ezra, Jonathan; Nasim, Suhail; Frable, William J.; Domański, Henryk; Carabias, E.; Dhimes, Patricia; Agustín, Pedro de; Gutiérrez, Eduardo; Ravinsky, Esther; Safneck, Janice R.; Chantziantoniou, Nick; Lee, Ji Shin; Lee, Min Cheol; Park, Chang Soo; Juhng, Sang Woo; Yusuf, Yasmin; Belmonte, A.; Tchertkoff, Victor

doi:10.1159/000333969

Cited by 66 publications

(5 citation statements)

References 58 publications

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“…The IAC YRSB uses terminology essentially identical to a previously published system for breast cytology proposed following a meeting in Bethesda, MD, USA [20-22]. This “Bethesda System” proposed the use of 5 categories (benign, atypical/indeterminate, suspicious/probably malignant, malignant, and unsatisfactory).…”

Section: Discussionmentioning

confidence: 99%

Interobserver Agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

et al. 2020

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Background: A number of guidelines have been developed to improve standardization of the terminology and criteria for cytologic specimens obtained from the thyroid, pancreas, lung, and salivary glands. A major goal of these guidelines is to improve reproducibility and understanding of the reporting of diagnostic results among cytopathologists and between cytopathologists and clinicians. The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology (IAC YSRB) is the most recent of these guidelines. The value of this system is, in part, dependent upon interobserver reproducibility. Design: Ninety consecutive fine-needle aspiration biopsies (FNAB) of the breast, performed over a 6-year period, were independently evaluated by 4 board-certified pathologists blinded to the original diagnoses. The 5 diagnostic categories used were those of the IAC YSRB according to published criteria for these categories. Observed agreement and chance corrected agreement (Fliess κ) were calculated. Differences in κ values were evaluated using the T statistic of Gwent. Statistical calculations were performed using STATA v16.0 (STATA Corp., College Station, TX, USA). Results: Overall agreement between observers was good. Observed unweighted agreement was 69% and weighted agreement was 91%. The majority of diagnoses were concordant (68.6%). Conclusions: Interobserver agreement of 4 cytopathologists was good using the 5 categories of the IAC YRSB (69%). Agreement was greater among pathologists with more years of experience. The IAC YSRB system appears to provide greater agreement among viewers than guidelines for cytologic specimens obtained from some other body sites (salivary gland and lung). Most discrepancies were only by a single category, with only 22/113 (19%) differing by more than one category.

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Section: Discussionmentioning

confidence: 99%

Interobserver Agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

et al. 2020

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“…[6] There have been studies to delineate the distinctive cytologic features of benign and malignant papillary lesions of the breast. [23] It has been suggested from these and other studies that malignant papillary lesions have high cellularity, complex branching papillary fragments, single intact atypical cells, absence of bland columnar cells and lack of foamy or hemosiderin-laden macrophages in the background.…”

Section: Discussionmentioning

confidence: 99%

Cytodiagnosis of papillary carcinoma of the breast: Report of a case with histological correlation

Aggarwal

Soin

Kalita

et al. 2014

J Cytol

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Papillary lesions of the breast pose diagnostic challenges on aspiration cytology due to overlapping features of benign and malignant entities. Accurate cytologic diagnosis of papillary breast carcinoma cannot usually be made pre-operatively. We present the case of an adult female who underwent fine-needle aspiration (FNA) of a left breast lump. FNA smears were highly cellular showing cohesive clusters, complex papillary fragments and few singly dispersed intact cells. The tumor cells had hyperchromatic nuclei, prominent nucleoli and mild nuclear pleomorphism. A cytologic impression of papillary lesion, possibly malignant (in view of high cellularity, complex papillae and single intact cells) was rendered. The lesion proved to be a papillary carcinoma with microscopic foci of stromal invasion on histologic examination. Papillary carcinoma, an uncommon subtype of breast carcinoma, should be considered while evaluating a papillary lesion with complex branching papillae containing delicate fibrovascular cores and singly lying intact atypical cells.

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“…The inclusion criteria were: (i) all the clinically suspected and preoperative fine-needle aspiration cytology (FNAC) confirmed[3] patients (Category 5) of breast carcinoma who had undergone mastectomy in the Department of Surgery and (ii) patients who gave the consent and fully cooperated during the study procedure. The exclusion criteria were: (i) breast carcinoma patients not confirmed by cytology (other than Category 5) and/or (ii) patients having a history of preoperative chemotherapy or radiotherapy for breast carcinoma.…”

Section: Methodsmentioning

confidence: 99%

“…[12] The National Cancer Institute (NCI), Bethesda, sponsored conference had also recommended that the tumor grading on FNA (fine needle aspiration) material should be incorporated in FNA reports for prognostication. [3]…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of six cytological grading systems in breast carcinoma

Kaushik

Raychaudhuri

Chattopadhyay

et al. 2013

J Cytol

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Background:Cytological grading is a useful tool for selection of therapy and prognosis in breast carcinoma. Despite having many cytological grading systems, there is still no agreement among pathologists to accept one of them as a gold standard.Aim:This study was undertaken to evaluate six such three-tier cytological grading systems to determine which system corresponds best to histological grading done by Nottingham modification of Scarff Bloom Richardson (SBR)'s method.Materials and Methods:In a double-blind study, preoperative cytological grades obtained by six systems on fine-needle aspiration cytology (FNAC) smears were compared by testing concordance, association and correlation with histological grade derived postoperatively by the SBR's method in 57 patients of breast carcinoma. Bivariate correlation studies and multiple linear regressions were done to assess the significance of the different cytological parameters to predict final cytological grades.Results:Robinson's system demonstrated the best correlation (ρ = 0.799; P = 0.000 and τ = 0.765; P = 0.000), maximum percent agreement (77.19%) and a substantial kappa value of agreement (κ = 0.62) with the SBR's grading system. All the six cytological grading systems correlated with histological grading strongly and positively. In multiple regression analysis, all of the cytological parameters of Robinson's system except cell size and nucleoli had significance in predicting the final cytological grade.Conclusions:Robinson's grading system is simple, more objective and reproducible, and demonstrated the best concordance with histological grading. So, Robinson's system should be used routinely for breast carcinoma aspirates.

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The Uniform Approach to Breast Fine Needle Aspiration Biopsy

Cited by 66 publications

References 58 publications

Interobserver Agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

Interobserver Agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

Cytodiagnosis of papillary carcinoma of the breast: Report of a case with histological correlation

Comparative evaluation of six cytological grading systems in breast carcinoma

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