FNAC as preoperative diagnostic tool for neoplastic and non-neoplastic breast lesions with special reference to IAC standardised reporting in Coastal population - A teaching hospital experience

Abstract

Breast cancer is steadily increasing worldwide. This study is based on application of recently proposed International Academy of cytology (IAC) Yokohama categorisation system of Breast cytology from C1 to C5. (C1-Insufficient material, C2-Benign, C3- Atypical, C4-Suspicious & C5-Malignant). We aim to categorize the breast lesions based on the above-mentioned categorization scheme (IAC, Yokohama 2016) along with histopathological correlation (wherever possible). This was a retrospective observational study conducted from January 2018 to December 2021 in the Department of Pathology of a tertiary care hospital involving coastal population. Ethical clearance was taken from institutional reviw committee. All patients with palpable breast lumps who had undergone FNAC were included in the study. Patient details and data were collected from the case records maintained in Department of Pathology. All quantitative parameters were described through descriptive statistics. Total scores were computed for all the risk factors. Sensitivity, specificity, Positive Predictive Value, Negative Predictive Value calculated. Risk of malignancy(ROM) was calculated for each category. A total 200 patients, with age group ranging from 17 - 67 years with breast lesions were included in the study. C1 lesions were found in 5 cases, C2 in 152 cases, C3 in 11 cases, C4 in 4 cases, and C5 in 28 cases. Cytohistological correlation obtained in 94 cases with concordance noted in 89 cases and discordance in 5 cases. Breast FNAC cytology categorization according to IAC Yokohama system increases accuracy of diagnosis and helps clinician in appropriate patient management.