Abolish C3

Arif, Syeda Faiza; Singh, Naveena

doi:10.1111/j.1365-2303.2003.00117.x

Cytopathology

2004

DOI: 10.1111/j.1365-2303.2003.00117.x

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Abolish C3

Syeda Faiza Arif

Naveena Singh

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“…zone that exists in FNAC of breast in cases where an unequivocal diagnosis cannot be made [5]. Instead, the categories of atypia probably benign (C3) and suspicious of malignancy (C4) provide a strategy for the classification of problematic or uncertain cases; this maintains the predictive value of the benign (C2) and malignant (C5) categories and allows separation of these difficult cases into clinically useful groups with differing probabilities of malignancy [6][7][8][9][10][11].…”

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Diagnostic Dilemmas in FNAC Cytology: Difficult Breast Lesions

Fine Needle Aspiration Cytology

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FNAC forms part of the triple assessment of breast lesions. The NHS Breast-Screening Programme (NHSBSP) established guidelines for the reporting of cytological material from FNAC breast along these lines, recommending the use of five reporting categories for breast cytology: C1, unsatisfactory; C2, benign; C3, suspicious -probably benign; C4, suspicious -probably malignant; C5, malignant [1]. In 1996, the National Cancer Institute (NCI) also recommended five categories for the diagnosis of breast FNAC: benign, atypical, suspicious, malignant and unsatisfactory [2]. Application of the NHSBSP and NCI-supported diagnostic categories to FNAC of palpable and non-palpable breast lesions is useful in stratifying aspirates based on the likelihood of underlying malignancy. The subcategories diagnosed as atypical have similar probabilities of malignancy; this justifies their being grouped as a single category wherein tissue biopsy would be required to exclude carcinoma. Benign and inadequate FNAC diagnoses must be correlated with the clinical and imaging findings and in non-correlative cases the patient should undergo biopsy. FNAC is a sensitive and specific means with which to diagnose non-palpable breast lesions [3]. The evaluation of cytological criteria used to differentiate benign from malignant lesions (i.e. cellularity, loss of cohesion, myoepithelial cells, nuclear enlargement, nuclear overlap, prominent nucleoli) reveals significant overlap between benign and malignant cases, particularly in cases of fibroadenoma, tubular adenoma and proliferative breast disease [4].Despite some of the shortcomings of the reporting categories described above, their constant use in daily practice has proved their value in describing the findings most accurately, if not always most helpfully. The latter relates to a grey

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Diagnostic Dilemmas in FNAC Cytology: Difficult Breast Lesions

Fine Needle Aspiration Cytology

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Abolish C3

Cited by 1 publication

References 1 publication

Diagnostic Dilemmas in FNAC Cytology: Difficult Breast Lesions

Diagnostic Dilemmas in FNAC Cytology: Difficult Breast Lesions

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