Abstract
BACKGROUND: International Academy of Cytology (IAC) introduced a breast category to produce comprehensive standardized guidelines for reporting breast cytopathology. IAC Yokohama System for Reporting Breast Cytopathology highlights the indications for getting breast cytology, procedural techniques, preparation of smear, material yielded, uniform system of reporting, use of ancillary investigations and prognostic tests, and correlation with clinical workup algorithms. The triple approach that includes clinical examination, radiological and pathological workup aims to maximize the preoperative detection of malignancy for early, definitive, appropriate treatment to the patient.
MATERIALS AND METHODS: The present study characterized the cytomorphological features of breast lesions ranging from inflammatory, benign to malignant. The lesions encountered were assigned a specific category on the basis of IAC Yokohama System. Histopathological correlation of cytomorphological findings was done wherever possible.
RESULTS: Out of a total of 450 cases included in our study, 98% (441/450) were females, male to female ratio of 1:49, mean age being 32.6 ± 12.5 years. Majority of cases were in Yokohama category benign comprising 345 breast aspirates (76.66%), followed by 40 cases (8.8%) malignant, 28 cases (6.22%) in Yokohama atypical category. Category suspicious for malignancy consisted of 17 (3.7%) cases. A good inter-kappa agreement was found between cytological impression and histopathology diagnosis (>0.5). A sensitivity and specificity of 100 and 92.96% respectively was seen along with positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of 98.24%, 100%, and 0.98 respectively. Diagnostic accuracy of 98.57% was seen.
CONCLUSION: The IAC Yokohama System is a high-quality reporting system used for diagnosing breast fine needle aspirates accurately with greater reproducibility of reports and better communication between the pathologist and clinician.