A STUDY ON FINE NEEDLE ASPIRATION CYTOLOGY OF BREAST LESIONS ACCORDING TO IAC YOKOHOMA CLASSIFICATION AND ITS HISTOPATHOLOGICAL CORRELATION, AT TERTIARY CARE HOSPITAL, GHAZIABAD
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Keywords
Breast lesions, Fine Needle Aspiration Cytology (FNAC), Histopathology, Diagnostic accuracy, IAC Yokohama classification, Sensitivity, Specificity, Malignant lesions, Benign lesions, Cytomorphological patterns, Breast cancer, Preoperative diagnosis.
Abstract
Breast lumps are a frequent concern among women and often present with symptoms such as pain, palpable masses, or nipple discharge. These symptoms can lead to considerable anxiety, though most breast lumps are benign. Fine Needle Aspiration Cytology (FNAC) offers a rapid, minimally invasive, and cost-effective diagnostic approach that helps differentiate between cystic and solid lesions and plays a crucial role in identifying malignancies. This study, conducted at the Pathology Department of Santosh Medical College, Ghaziabad, aimed to assess the cytomorphological patterns of breast lesions using FNAC, evaluate its diagnostic accuracy, and correlate findings with histopathological results using the IAC Yokohama classification. Over a year, 258 patients underwent FNAC, with histopathological follow-up available for 136 cases. FNAC showed high diagnostic performance, with a sensitivity of 92.86%, specificity of 100%, and overall accuracy of 93.8%. The majority of cases were benign (C2), and most lesions measured between 2–5 cm. These findings reinforce FNAC’s critical role in the early, accurate, and reliable preoperative assessment of breast lesions.
References
2. Ahmad F, Mittal A, Verma P, Kumar A, Awasthi S, Dutta S. Cytomorphological study of palpablebreastlumps:SpectrumoflesionsanddiagnosticutilityofFNAC.AnnIntMedDent Res. 2016 Jul-Aug;2(4):237-41.
3. Dennison G, Anand R, Makar SH, Pain JA. A prospective study of the use of fine-needle aspiration cytology and core biopsy in the diagnosis of breast cancer. Breast J. 2003 Nov- Dec;9(6):491-3.
4. Kocjan G. Evaluation of the cost effectiveness of establishing a fine needle aspiration cytology clinic in a hospital out-patient department. Cytopathology. 1991;2(1):13-8.
5. Rosa M, Mohammadi A, Massod S. The value of fine needle aspiration biopsy in the diagnosis and prognostic assessment of palpable breast lesions. DiagnCytopathol. 2008 May;36(5):303-10.
6. Muddegowda PH, Lingegowda JB, Kurpad R, Konapur PG, Shivarudrappa AS, Subramaniam PM. The value of systematic pattern analysis in FNAC of breast lesions: 225 cases with cytohistological correlation. Journal of Cytology. 2011 Jan 1;28(1):13-9.
7. Qadri S, Khan SP, Farooq S, Bhat AR. Cytomorphological pattern of breast lesions diagnosed on fine-needle aspiration cytology in a district hospital in Kashmir valley. IntJAdv Med 2022 Jul;9:814-7.
8. Chaiwun B, Settakorn J, Ya-InC, Wisedmongkol W, Rangdaeng S, Thorner P. Effectiveness of fine-needle aspiration cytology of breast: analysis of 2,375 cases from northern Thailand. DiagnCytopathol. 2002 Mar;26(3):201-5.
9. Nguansangiam S, Jesdapatarakul S, Tangjitgamol S. Accuracy of fine needle aspiration cytology from breast masses in Thailand. Asian Pac J Cancer Prev. 2009 Oct-Dec;10(4):623
10. Kalhan S, Dubey S, Sharma S, Dudani S, Preeti, Dixit M. Significance of nuclear morphometry in cytological aspirates of breast masses. J Cytol. 2010 Jan;27(1):16-21.
11. Martin HE, Ellis EB. Biopsy by needle puncture and aspiration. Annals of surgery. 1930Aug;92(2):169.
12. Franzen S, Zajicek J. Aspiration biopsy in diagnosis of palpable lesions of the breast: critical review of 3479 consecutive biopsies. Acta Radiol Ther Phy sBiol.1968 Aug;7:241-62.
13. Siegel RL, Miller KD, Jemal A. Cancer statistics 2015. CA:A Cancer J Clin .2015 Jan- Feb;65:5-29.
14. Ahmad N, Kalsoom S, Mahmood Z, Comparative evaluation of selected sex hormones in premenopausal and postmenopausal women with breast cancer Int J Biosci. 2019 Dec 18;15(6):16-25.
15. Place R, Velanovich V, Carter P. Fine needle aspiration in the clinical management of mammary masses. Surg Gynecol Obstet. 1993 Jul;177(1):7-11.
16. Guidelines for cytology procedures and reporting on fine needle aspirates of the breast. Cytology Subgroup of the National Coordinating Committee for Breast Cancer Screening Pathology. Cytopathology. 1994 Oct;5(5):316-34.
17. Editorial working party, Wells CA, EllisIO, Zakhour HD,Wilson AR. Cytology subgroup of the national coordinating committee for breast cancer screening pathology. Guidelines for cytology procedure sand reporting on fine needle aspirates of the breast. Cytopathology.1994 Oct;5:316-34.
18. Tabbara SO,FrostAR, Stoler MH, Sneige N, Sidawy MK. Changing trends in breast fine- needle aspiration: results of the Papanicolaou Society of Cytopathology Survey. Diagn Cytopathol. 2000 Feb;22(2):126-30.
19. Berner A, Davidson B, Sigstad E, Risberg B. Fine-needle aspiration cytology vs. core biopsy in the diagnosis of breast lesions. DiagnCytopathol. 2003 Dec;29(6):344-8.
20. Simsir A, Rapkiewicz A, Cangiarella J. Current utilization of breast FNA in a cytology practice. DiagnCytopathol. 2009 Feb;37(2):140-2.
21. 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 May 20;63(4):280-91.
22. Bukhari MH, Arshad M, Jamal S, Niazi S, Bashir S, Bakhshi IM, Shaharyar. Use of fine- needle aspiration in the evaluation of breast lumps. Patholog Res Int. 2011;2011:689521.
23. Chandanwale SS, Gupta K, Dharwadkar AA, Pal S, Buch AC, Mishra N. Pattern of palpable breast lesions on fine needle aspiration: A retrospective analysis of 902 cases. J Midlife Health. 2014 Oct;5(4):186-91.
24. Rioki JN, Muchiri L, Mweu M, Songok E, Rogena E. Cytomorphological patterns of breast lesions among women with palpable breast lumps attending select teaching and referral hospitals in Kenya: a descriptive cross-sectional study. Pan Afr Med J. 2023 Apr 13;44:171.
25. Panwar H, Ingle P, Santosh T, Singh V, Bugalia A, Hussain N. FNAC of Breast Lesions with Special Reference to IAC Standardized Reporting and Comparative Study of Cytohistological Grading of Breast Carcinoma. J Cytol. 2020 Jan-Mar;37(1):34-39. doi: 10.4103/JOC.JOC_132_18. Epub 2019 Dec 23. PMID: 31942096; PMCID: PMC6947736.
26. Brahmaiah J, Bhavadeep S, Kumar VH, Malapaka S, Govardhan T, Rentala S. A study to classify the fine needle aspirates of breast lumps as per the IAC Yokohama system for reporting breast cytopathology along with histopathological correlation. Onkologia i Radioterapia. 2024;18(4)
27. Ibikunle DE, Omotayo JA, Ariyibi OO. Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: a five-year review. Ghana Med J. 2017 Mar;51(1):1-5. doi: 10.4314/gmj.v51i1.1. PMID: 28959065; PMCID: PMC5611949.
28. Khanam KF, Akter N, Tabashum T, Raza AKM, Hosna AU, Rahman F, Begum A. A Clinicopathologic Study of Various Breast Lesions by Fine Needle Aspiration Cytology (FNAC). J Curr Surg. 2018;8(3-4):27-31. doi: 10.14740/jcs366w.
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Dr Swarnim Baidya
Junior resident, Department of Pathology, Santosh Medical College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh. Email- sbaidya028@gmail.com
Dr Swati Singh
Professor, Department of Pathology, Santosh Medical College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh. Email- swati_singh3077@yahoo.com
Dr Richa Sharma
Assistant Professor, Department of Pathology, Santosh Medical College, Santosh Deemed to be University, Ghaziabad, Uttar Pradesh. Email- richasharmamrt44@gmail.com
Dr Adreena Mittal
Head of department and professor, Department of pathology, Santosh medical college, Santosh deemed to be university, Ghaziabad, Uttar Pradesh, Email-dradreena@gmail.com