Munjal Priyanka, Singh Meeta, Bhatt Vipul Ranjan, Gautam Rashmi, Singh Gurmeet, Khurana Nita, Jain Shyama, Verma Nidhi, Bains Lovenish, Goel Lavanya, Baweja Ritwik, Batra Radhika, Lal Pawanindra
Department of Pathology, ESIC Hospital & PGIMSR, Basaidarapur, New Delhi, India.
Department of Pathology, Maulana Azad Medical College, New Delhi, India.
J Cytol. 2025 Apr-Jun;42(2):88-94. doi: 10.4103/joc.joc_25_24. Epub 2025 May 29.
The International Academy of Cytology (IAC) Yokohama System has developed a standardized system of reporting breast cytology. The current study aimed to apply the newly proposed YOKOHAMA classification system along with American College of Radiology Breast Imaging Reporting and Data system (ACR-BI-RADS) scoring to breast fine-needle aspiration cytology (FNAC) cases from the department archives and to assess the risk of malignancy (ROM) for each category.
All breast FNACs done between January 20017 and June 2023 were reclassified according to the proposed IAC Yokohama reporting system. Histopathological correlation of the IAC Yokohama system and BI-RADS was done wherever available. A three-category approach was followed based on benign versus malignant, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using histopathology as the gold standard.
A total of 2130 breast FNACs were performed, of which 469 had a histopathological correlation and 892 had a BI-RADS correlation. The ROM for insufficient, benign, atypical, suspicious, and malignant categories were 29.16%, 3.28%, 28.57%, 100%, and 92.18%, respectively. Maximum specificity (96.8%) was observed when only malignant (cat A) and when both suspicious and malignant cases (Cat B) were taken as positive test results. Highest sensitivity (92.7%) was achieved when atypical, suspicious, and malignant cases were taken as positive test results (Cat C) and highest diagnostic accuracy (94.8%) was seen in category B. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of BI-ADS were 78.67%, 92%, 85.5%, 87.8%, and 87%, respectively.
FNAC and imaging are the key modalities for diagnosing breast lesions. The IAC Yokohama system along with ACR-BI-RADS provides a simple yet useful approach for effectively categorizing the different breast lesions, which is useful for patient management and risk stratification.
国际细胞学会（IAC）横滨系统已开发出一种标准化的乳腺细胞学报告系统。本研究旨在将新提出的横滨分类系统与美国放射学会乳腺影像报告和数据系统（ACR - BI - RADS）评分应用于科室档案中的乳腺细针穿刺细胞学检查（FNAC）病例，并评估每个类别的恶性风险（ROM）。
根据提议的IAC横滨报告系统，对2017年1月至2023年6月期间进行的所有乳腺FNAC进行重新分类。只要可行，就对IAC横滨系统和BI - RADS进行组织病理学相关性分析。采用基于良性与恶性的三类方法，并以组织病理学为金标准计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和诊断准确性。
共进行了2130例乳腺FNAC，其中469例有组织病理学相关性，892例有BI - RADS相关性。不足、良性、非典型、可疑和恶性类别的ROM分别为29.16%、3.28%、28.57%、100%和92.18%。仅将恶性（A类）以及可疑和恶性病例（B类）都视为阳性检测结果时，观察到最大特异性（96.8%）。当非典型、可疑和恶性病例被视为阳性检测结果（C类）时，实现了最高敏感性（92.7%），B类的诊断准确性最高（94.8%）。BI - ADS的敏感性、特异性、PPV、NPV和诊断准确性分别为78.67%、92%、85.5%、87.8%和87%。
FNAC和影像学是诊断乳腺病变的关键方式。IAC横滨系统与ACR - BI - RADS一起提供了一种简单但有用的方法，可有效对不同乳腺病变进行分类，这对患者管理和风险分层很有用。
