Prospective evaluation of accuracy of fine‐needle aspiration biopsy for breast lesions using the International Academy of Cytology Yokohama System for reporting breast cytopathology

Abstract

Background Classification of breast lesions into different cytological groups can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy (FNAB) of breast lesions has been considered to be the primary investigation in detecting breast cancers, especially in low‐cost settings. The main objective of this study was to prospectively re‐confirm the diagnostic accuracy of breast FNAB using the IAC Yokohama system. Additionally, separate secondary subgroup analysis was done to confirm the accuracy of breast FNAB excluding lymph‐node positive and lymphadenopathy positive tumors. Material and methods A prospective study was done on patients undergoing biopsy of breast lesions between September 01, 2019 and November 30, 2020 (519 biopsies on 487 unique patients). Of these 519 histopathology biopsies, 505 had corresponding FNAB report of the same site. The FNAB was reported using the IAC Yokohama system and the most suitable category was allotted in every case. The rates of malignancy for each category and the accuracy of breast FNAB in diagnosing malignancy were calculated. Results Of the total 487 patients, 120 cases were benign on histology, while 367 were malignant. The rates of malignancy in benign, atypical, suspicious and malignant categories were 5%, 25%, 71%, and 99.7%, respectively. The diagnostic accuracy of atypical, suspicious and malignant categories was calculated as 90.1%, 95.2%, and 93.3%, respectively. Conclusion The high diagnostic accuracy for each BIRADS category suggest excellent accuracy for Breast FNAB using the IAC Yokohama system.

The Use of the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy

“…All 18 eligible studies were published between 2019 and 2021, and most of them (n = 11) were conducted in India. Most were retrospective (n = 16), whereas two 19 , 30 followed a prospective design. None of the authors reported the sole use of liquid-based cytology as their cytopreparation method.…”

Insufficient/inadequate category in breast cytology: Are the standardized guidelines of rapid on‐site evaluation available to reduce its rate?

“…These studies report ROM in the different categories of IACYS. The ROM was ranged in categories II 0.4% to 8.3%, III 1.3% to 50%, IV 55.55% to 100%, and V 97% to 100% 4–18 . The ROM in category I without ROSE ranges from 0% to 60.87% 4–18 and 0% to 11.11% 8,17 with ROSE.…”

Evaluation of the rational use of the cytological method in the diagnostics of the breast diseases using the Yokohama system

“…В работе S. Agrawal и соавт. (2021) проведена проспективная оценка точности ТИАБ при поражениях молочной железы с использованием Йокогамской системы, в которой авторы показали высокую диагностическую точность для каждой категории BI-RADS [22].…”