Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System
Mahwish Niaz,1,2 Azmat Ali Khan,3 Safina Ahmed,2 Rabia Rafi,4 Hassan Salim,5 Kashaf Khalid,6 Faiza Kazi,1,7 Awais Anjum,8 Yasir Waheed6 1Department of Pathology, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan; 2Department of Pathology, Shifa Tameer-e-Mill...
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| Format: | Article |
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Dove Medical Press
2022-05-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/risk-of-malignancy-in-breast-fnab-categories-classified-according-to-t-peer-reviewed-fulltext-article-CMAR |
| _version_ | 1818195717028577280 |
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| author | Niaz M Khan AA Ahmed S Rafi R Salim H Khalid K Kazi F Anjum A Waheed Y |
| author_facet | Niaz M Khan AA Ahmed S Rafi R Salim H Khalid K Kazi F Anjum A Waheed Y |
| author_sort | Niaz M |
| collection | DOAJ |
| description | Mahwish Niaz,1,2 Azmat Ali Khan,3 Safina Ahmed,2 Rabia Rafi,4 Hassan Salim,5 Kashaf Khalid,6 Faiza Kazi,1,7 Awais Anjum,8 Yasir Waheed6 1Department of Pathology, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan; 2Department of Pathology, Shifa Tameer-e-Millat University, Islamabad, Pakistan; 3Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Pathology, Isfand Bukhari District Hospital, Attock, Pakistan; 5Department of Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan; 6Clinical and Biomedical Research Center, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan; 7Department of Pathology, PAEC Hospital, Islamabad, Pakistan; 8ParkinElmer Inc., Newport, UKCorrespondence: Yasir Waheed, Clinical and Biomedical Research Center, Foundation University Medical College, Foundation University Islamabad, DHA-1, Islamabad, Pakistan, Email yasir_waheed_199@hotmail.comBackground: A new category system comprising five classes (C1-insufficient material, C2-benign, C3-atypical, C4-suspicious, and C5-malignant) has been proposed by the International Academy of Cytology (IAC) for fine needle aspiration biopsy cytology (FNAB) for proper diagnosis of breast cancer.Aims and Objectives: This study is designed to categorize institutional FNAB data according to the new system and calculation of the absolute risk of malignancy (ROM), sensitivity, specificity, positive predictive values, false negative and false-positive rate.Study Design: We conducted a retrospective cross-sectional study involving 2133 cases collected between June, 2008 and August, 2019, at Foundation University Medical College’s Department of Histopathology and the Surgery and Oncology Department at the Fauji Foundation Hospital. All cases fulfilling the inclusion and exclusion criteria were retrieved from the archives and reviewed by two expert pathologists. Matching histopathology was compared with the cytology reports for concordance or discordance of results.Findings: We found 6.9% (n = 147) insufficient, 65.8% (n = 1403) benign, 7.2% (n = 153) atypical, 7.5% (n = 160) suspicious and 12.6% (n = 270) malignant cases. Cyto-histological correlation was found in 421 cases from the year 2014 to 2019 with 370 concordant and 51 discordant cases. The maximum number of concordant cases was 151 in the C5 category and discordant cases had a diagnosis of C3 and C4 on cytology with 16 cases in each category. The calculated values of ROM were 45.45%, 10.3%, 30.6%, 82.79% and 99.34% from C1 to C5, respectively. We calculated 83.42% absolute sensitivity and 85.24% specificity. The positive predictive value for category 3, 4 and 5 was 67.34%, 82.7% and 99.34%, respectively, while false-negative rate was 7.9% and false-positive rate was 0.66%.Conclusion: The ROM for C1 category calculated from this study is quite high (45.45%) compared to previous studies; therefore, it is recommended to perform core needle biopsy in all these cases. The higher sensitivity and specificity of this method of diagnosing malignant lesions supports its use.Keywords: IAC Yokohama system, fine needle aspiration biopsy, core needle biopsy, risk of malignancy, benign, rapid onsite evaluation |
| first_indexed | 2024-12-12T01:22:37Z |
| format | Article |
| id | doaj.art-1579df724d9c4cdca9278a645dec129d |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-12T01:22:37Z |
| publishDate | 2022-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-1579df724d9c4cdca9278a645dec129d2022-12-22T00:43:11ZengDove Medical PressCancer Management and Research1179-13222022-05-01Volume 141693170175137Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama SystemNiaz MKhan AAAhmed SRafi RSalim HKhalid KKazi FAnjum AWaheed YMahwish Niaz,1,2 Azmat Ali Khan,3 Safina Ahmed,2 Rabia Rafi,4 Hassan Salim,5 Kashaf Khalid,6 Faiza Kazi,1,7 Awais Anjum,8 Yasir Waheed6 1Department of Pathology, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan; 2Department of Pathology, Shifa Tameer-e-Millat University, Islamabad, Pakistan; 3Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4Department of Pathology, Isfand Bukhari District Hospital, Attock, Pakistan; 5Department of Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan; 6Clinical and Biomedical Research Center, Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan; 7Department of Pathology, PAEC Hospital, Islamabad, Pakistan; 8ParkinElmer Inc., Newport, UKCorrespondence: Yasir Waheed, Clinical and Biomedical Research Center, Foundation University Medical College, Foundation University Islamabad, DHA-1, Islamabad, Pakistan, Email yasir_waheed_199@hotmail.comBackground: A new category system comprising five classes (C1-insufficient material, C2-benign, C3-atypical, C4-suspicious, and C5-malignant) has been proposed by the International Academy of Cytology (IAC) for fine needle aspiration biopsy cytology (FNAB) for proper diagnosis of breast cancer.Aims and Objectives: This study is designed to categorize institutional FNAB data according to the new system and calculation of the absolute risk of malignancy (ROM), sensitivity, specificity, positive predictive values, false negative and false-positive rate.Study Design: We conducted a retrospective cross-sectional study involving 2133 cases collected between June, 2008 and August, 2019, at Foundation University Medical College’s Department of Histopathology and the Surgery and Oncology Department at the Fauji Foundation Hospital. All cases fulfilling the inclusion and exclusion criteria were retrieved from the archives and reviewed by two expert pathologists. Matching histopathology was compared with the cytology reports for concordance or discordance of results.Findings: We found 6.9% (n = 147) insufficient, 65.8% (n = 1403) benign, 7.2% (n = 153) atypical, 7.5% (n = 160) suspicious and 12.6% (n = 270) malignant cases. Cyto-histological correlation was found in 421 cases from the year 2014 to 2019 with 370 concordant and 51 discordant cases. The maximum number of concordant cases was 151 in the C5 category and discordant cases had a diagnosis of C3 and C4 on cytology with 16 cases in each category. The calculated values of ROM were 45.45%, 10.3%, 30.6%, 82.79% and 99.34% from C1 to C5, respectively. We calculated 83.42% absolute sensitivity and 85.24% specificity. The positive predictive value for category 3, 4 and 5 was 67.34%, 82.7% and 99.34%, respectively, while false-negative rate was 7.9% and false-positive rate was 0.66%.Conclusion: The ROM for C1 category calculated from this study is quite high (45.45%) compared to previous studies; therefore, it is recommended to perform core needle biopsy in all these cases. The higher sensitivity and specificity of this method of diagnosing malignant lesions supports its use.Keywords: IAC Yokohama system, fine needle aspiration biopsy, core needle biopsy, risk of malignancy, benign, rapid onsite evaluationhttps://www.dovepress.com/risk-of-malignancy-in-breast-fnab-categories-classified-according-to-t-peer-reviewed-fulltext-article-CMARiac yokohama systemfine needle aspiration biopsycore needle biopsyrisk of malignancybenignrapid onsite evaluation |
| spellingShingle | Niaz M Khan AA Ahmed S Rafi R Salim H Khalid K Kazi F Anjum A Waheed Y Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System Cancer Management and Research iac yokohama system fine needle aspiration biopsy core needle biopsy risk of malignancy benign rapid onsite evaluation |
| title | Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System |
| title_full | Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System |
| title_fullStr | Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System |
| title_full_unstemmed | Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System |
| title_short | Risk of Malignancy in Breast FNAB Categories, Classified According to the Newly Proposed International Academy of Cytology (IAC) Yokohama System |
| title_sort | risk of malignancy in breast fnab categories classified according to the newly proposed international academy of cytology iac yokohama system |
| topic | iac yokohama system fine needle aspiration biopsy core needle biopsy risk of malignancy benign rapid onsite evaluation |
| url | https://www.dovepress.com/risk-of-malignancy-in-breast-fnab-categories-classified-according-to-t-peer-reviewed-fulltext-article-CMAR |
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