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International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution

Introduction: Breast carcinoma is the most common malignancy amongst women in South Africa. Triple assessment has been pivotal in the work up and management of breast carcinoma. Breast cytology has been used as a component of the triple assessment. Although core needle biopsy (CNB) is the gold stand...

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Main Author: Pamacheche, Patricia Nee Pariza
Other Authors: Chetty, Dharshnee Rama
Format: Thesis
Language:English
Published: Department of Pathology 2022
Subjects:
Anatomical Pathology
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access_status_str Open Access
author Pamacheche, Patricia Nee Pariza
author2 Chetty, Dharshnee Rama
author_browse Chetty, Dharshnee Rama
Pamacheche, Patricia Nee Pariza
author_facet Chetty, Dharshnee Rama
Pamacheche, Patricia Nee Pariza
author_sort Pamacheche, Patricia Nee Pariza
collection Thesis
description Introduction: Breast carcinoma is the most common malignancy amongst women in South Africa. Triple assessment has been pivotal in the work up and management of breast carcinoma. Breast cytology has been used as a component of the triple assessment. Although core needle biopsy (CNB) is the gold standard and the preferred diagnostic modality, there is still a role for fine needle aspirate cytology (FNAC) in resource limited settings. The present study was conducted at Groote Schuur Hospital in Cape Town, South Africa. Aims: 1. To assess the utility of the International Academy of Cytology (IAC) Yokohama System for Reporting Breast FNAC five category stratifications in our institution. 2. To assess the respective risk of malignancy (ROM) for each category. 3. To assess the diagnostic yield of the breast FNAB at our institution by comparing it to the matched histopathology over a 12-month period. Methodology: A retrospective longitudinal descriptive study was done. A computerized search on TrakCare NHLS for the year 2019, identified 884 patients who had breast cytology and corresponding histology specimens. The cytology categories(C1-C5) were first reclassified according to the IAC Yokohama system. The new cytology category was then compared to the histological diagnosis for each patient. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and risk of malignancy (ROM) were calculated. Results: The sensitivity, specificity, PPV, and NPV were 83.10%, 93.01%, 88.86% and 89.13% respectively. The Cohen's kappa coefficient was 0.659 and percentage agreement was 80.85%. The ROM was calculated; insufficient (9.09%), benign (4.46%), atypia (45.28%), suspicious for malignancy (72.5%) and malignant (91,09%). Conclusion: Breast aspiration cytology performed at GSH has shown good correlation with histopathology as well a high sensitivity and specificity comparable to international standards. The ROM is comparable to previous similar studies. Overall, our results show that breast aspiration cytology is a rapid, accurate and cost-effective diagnostic procedure in our institution that is very useful in the diagnosis of benign and malignant breast lesions.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:33:08.525Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2022
publishDateRange 2022
publishDateSort 2022
publisher Department of Pathology
publisherStr Department of Pathology
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/35506 International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution Pamacheche, Patricia Nee Pariza Chetty, Dharshnee Rama Anatomical Pathology Introduction: Breast carcinoma is the most common malignancy amongst women in South Africa. Triple assessment has been pivotal in the work up and management of breast carcinoma. Breast cytology has been used as a component of the triple assessment. Although core needle biopsy (CNB) is the gold standard and the preferred diagnostic modality, there is still a role for fine needle aspirate cytology (FNAC) in resource limited settings. The present study was conducted at Groote Schuur Hospital in Cape Town, South Africa. Aims: 1. To assess the utility of the International Academy of Cytology (IAC) Yokohama System for Reporting Breast FNAC five category stratifications in our institution. 2. To assess the respective risk of malignancy (ROM) for each category. 3. To assess the diagnostic yield of the breast FNAB at our institution by comparing it to the matched histopathology over a 12-month period. Methodology: A retrospective longitudinal descriptive study was done. A computerized search on TrakCare NHLS for the year 2019, identified 884 patients who had breast cytology and corresponding histology specimens. The cytology categories(C1-C5) were first reclassified according to the IAC Yokohama system. The new cytology category was then compared to the histological diagnosis for each patient. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and risk of malignancy (ROM) were calculated. Results: The sensitivity, specificity, PPV, and NPV were 83.10%, 93.01%, 88.86% and 89.13% respectively. The Cohen's kappa coefficient was 0.659 and percentage agreement was 80.85%. The ROM was calculated; insufficient (9.09%), benign (4.46%), atypia (45.28%), suspicious for malignancy (72.5%) and malignant (91,09%). Conclusion: Breast aspiration cytology performed at GSH has shown good correlation with histopathology as well a high sensitivity and specificity comparable to international standards. The ROM is comparable to previous similar studies. Overall, our results show that breast aspiration cytology is a rapid, accurate and cost-effective diagnostic procedure in our institution that is very useful in the diagnosis of benign and malignant breast lesions. 2022-01-18T09:07:45Z 2022-01-18T09:07:45Z 2021 2022-01-12T11:45:02Z Master Thesis Masters MMed http://hdl.handle.net/11427/35506 eng application/pdf Department of Pathology Faculty of Health Sciences
spellingShingle Anatomical Pathology
Pamacheche, Patricia Nee Pariza
International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
thesis_degree_str Master's
title International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
title_full International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
title_fullStr International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
title_full_unstemmed International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
title_short International Academy of Cytology Yokohama System for reporting Breast Fine Needle Aspiration Biopsy (FNAB) cytology: A Retrospective Study in a Single South African Tertiary Institution
title_sort international academy of cytology yokohama system for reporting breast fine needle aspiration biopsy fnab cytology a retrospective study in a single south african tertiary institution
topic Anatomical Pathology
url http://hdl.handle.net/11427/35506
work_keys_str_mv AT pamachechepatricianeepariza internationalacademyofcytologyyokohamasystemforreportingbreastfineneedleaspirationbiopsyfnabcytologyaretrospectivestudyinasinglesouthafricantertiaryinstitution

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