Correlation of Fine Needle Aspiration of Breast Lesions (IAC categories) with histopathology and emphasis on code 3 and 4.

Abstract

Context: Fine needle aspiration is one of the most important diagnostic modalities used in triaging of breast lesions. Recent recommendations by international academy of cytologists have suggested a com-prehensive and standardised approach to breast cytology using 5 tier coding system (Code 1 – Code 5). Ob-jectives: To reclassify the previous fine needle aspiration cytology of breast according to IAC recommenda-tions and compare them with histological outcome and assess the diagnostic value of cytological diagnosis of Code 3 and Code 4 (C3 and C4) in predicting the benign and malignant cases confirmed on histopatholo-gy. Materials and Methods: Retrospective study done in the cytology section of department of pathology from January 2016 to April 2017. Institutional ethical clearance was taken before start of study. All cytology cases were rescreened and categorized into codes 1 to 5. Sixty seven cases were included in the study. His-topathological diagnosis was considered as gold standard. Corresponding histopathology details and slides whenever available were retrieved, analysed and documented. Statistical Analysis: Descriptive statistics and Chi square test was applied Results: Out of sixty seven cases included in our study, maximum number belonged to code 2. All cases diagnosed as code 2 were diagnosed as benign, while one case of code 5 was misdiagnosed as malignant, inspite of being hyperplastic lesion. Ability of code 3, code 4 in differentiating benign and malignant lesions was statistically significant. (p<0.05) Conclusion: IAC coding format of breast helps in triaging of benign and malignant cases, Code 3 and Code 4 have varying possibility of being malig-nant. Key-words: Breast cytology, Coding, C3 and C4 categories