Breast Fine Needle Aspiration Cytology Research Articles

Cytomorphological spectrum of breast fine needle aspiration cytology using the International Academy of Cytology Yokohama System and evaluation of associated risk of malignancy–A retrospective study in a tertiary care cente

BackgroundFine-needle aspiration cytology (FNAC) of the breast is a well-established technique that aids in the preoperative identification and differentiation between nonneoplastic and neoplastic breast lesions. Breast lesions can be efficiently categorized into different cytological groups using the International Academy of Cytology (IAC) Yokohama System. The aim of this study was to classify breast lesions based on the proposed Yokohama system of reporting breast cytology and identify the need for a unified system of reporting breast lesions.Materials and methodsThis retrospective descriptive study was performed in the Department of Pathology, Government Medical College, Datia, M.P. from January 2019 to June 2023. A total of 762 FNAC slides reported during this period were retrieved, re-examined and reclassified according to the IAC Yokohama System. Histopathological diagnoses were also retrieved and correlated with the cytological findings wherever available.ResultsIn the present study, a total of 762 smears of breast fine needle aspirations were included and categorized using the IAC Yokohama System. There were 3.8% cases (29/762) in the C1 category (insufficient), 71.6% cases (545/762) in the C2 category (benign), 6.3% cases (48/762) in the C3 category (atypical), 3.1% cases (24/762) in the C4 category (suspicious for malignancy) and 15.2% (116/762) cases in the C5 category (malignant).ConclusionFNAC is a reliable diagnostic technique for the evaluation and management of breast lesions prior to surgery. Implementing the IAC Yokohama System for reporting breast cytopathology enhances the accuracy of diagnosing breast lesions, reduces missed diagnoses, and offers reliable estimates of risk of malignancy. Adopting the Yokohama system is a crucial first step in boosting the overall effectiveness of breast cytology reporting among clinicians and pathologists, which will ultimately lead to improved communication and patient care.

Utilizing the Yokohama System of the International Academy of Cytology to Report Breast Fine Needle Aspiration Cytology

Utilizing the Yokohama System of the International Academy of Cytology to Report Breast Fine Needle Aspiration Cytology

Predictors of an informative or actionable cytological diagnosis on repeat breast aspiration after an insufficient aspirate: a multicentre retrospective review

An insufficient/inadequate diagnosis on fine-needle aspiration cytology (FNAC) of the breast is not an uncommon diagnostic dilemma. This study aims to review the rate and clinical features predicting an informative...

A RETROSPECTIVE COHORT STUDY IN AN INDIAN TERTIARY CARE HOSPITAL ON BREAST LESION CLASSIFICATION BY THE IAC YOKOHAMA SYSTEM USING FNAC

Objective: The International Academy of Cytology (IAC) Yokohama system was used to categorize breast lesions as the major goal of this investigation. Methods: Between January 2022 and March 2023, this study on breast fine needle aspiration cytology (FNAC) was carried out at a tertiary care facility in north India. This System of reporting breast cytopathology was used to classify a total of 100 patients. Histopathology correlation was available in 40 cases; Malignancy risk, sensitivity, specificity, and diagnostic precision were assessed. Results: Breast FNAC cytology was divided into five groups using the new IAC Yokohama system and discovered C1: Insufficient material (6%), C2: Benign type (72%), C3: Atypical type (05%), C4: Suspicious type of malignancy (06%), C5: Malignancy (11%). When histopathological reports were available, FNACs were connected with them. The likelihood of cancer, the precision, sensitivity, and specificity of the diagnosis were all calculated. Conclusion: The IAC Yokohama System for reporting breast cytopathology governs how breast FNAC are categorized, which offers an excellent method for reporting breast cytopathology with a uniform method of reporting and clear definition of each category as well as clear communication between pathologists and clinicians regarding the risk of malignancy and subsequent management.

The role of clinical breast examination and fine needle aspiration cytology in early detection of breast cancer: A cross-sectional study nested in a cohort in a low-resource setting.

Breast cancer is prevalent worldwide, with disparities in screening, diagnosis, treatment outcomes, and survival. In Africa, the majority of women are diagnosed at advanced stages, affecting treatment outcomes. Screening is one of the best strategies to reduce mortality rates caused by this cancer. Yet in a resource-constrained setting, there is limited access to screening and early detection services, which are available only at a few referral hospitals. We aimed to evaluate the prevalence and screening results of breast cancer using clinical breast examination coupled with fine needle aspiration cytology in a resource-constraint setting. A combined cross-sectional and cohort study. Women at risk of developing breast cancer in the Kilimanjaro region of Tanzania were invited, through public announcements, to their primary healthcare facilities. A questionnaire was used to assess the participants' characteristics. The women received a clinical breast examination, and detectable lesions were subjected to a confirmatory fine needle aspiration cytology or an excisional biopsy. Preliminary data from this ongoing breast cancer control program were extracted and analyzed for this study. A total of 3577 women were screened for breast cancer; their mean age was 47 ± 7.53 years. About a third of them (1145, 32%) were practicing self-breast examination at least once a month. Of 200 (5.6%) with abnormal clinical breast examination, 18 (9%) were confirmed to be breast cancer, making the prevalence to be 0.5%. The vast majority of participants with breast cancer (13, 72.2%) had early disease stages, and infiltrating ductal carcinoma, no special type, was the most common (15, 83.3%) histopathology subtype. Hormonal receptor status determination results indicated that 11 (61.1%), 7 (38.9%), and 5 (27.8%) of the tumors overexpressed estrogen receptor, progesterone receptor, and human epidermal receptor-2, respectively. Our study demonstrates 5.6% of Tanzanian women have abnormal clinical breast examination findings, with 9% having breast cancer. Nearly three-quarters (72.2%) of breast cancer screened for early disease were detected in the early disease stages. This finding suggests that organized screening with clinical breast examination coupled with fine needle aspiration cytology, which is a simple and cost-effective screening method, has the potential to improve early detection and outcomes for breast cancer patients in a resource-constraint setting.

Cell Block-Based Two-Dimensional and Immunocytochemical Analyses Could Reduce Atypical/Indeterminate Case Frequency in Breast Fine-Needle Aspiration Cytology: A Retrospective Analysis

Introduction: In fine-needle aspiration of the breast (FNAB), the “atypical” category encompasses both benign and malignant lesions, particularly papillary proliferative lesions, as per the latest WHO classification. We aimed to reduce atypical cases and improve diagnostic accuracy by investigating the utility of cell block (CB) analysis. Methods: FNAB CB samples (2018–2022) were reviewed using smear only or CBs. CB-based diagnosis was performed with 2D morphological analysis and immunocytochemistry using ER, CK5/6, p63, SMA, and CD56. Samples were reclassified as “benign,” “atypical,” “suspicious of malignancy,” “malignant,” or “insufficient/inadequate.” Atypical cases were reexamined. Diagnoses were validated histologically. Results: On examining the FNAB samples (n = 149; 32 atypical), 2D CB sectioning achieved a clearer definition of myoepithelial cells and fibrovascular cores than Papanicolaou staining. Immunocytochemistry was evaluated for 36 cases: estrogen receptor (ER)⁻ and CK5/6⁺ tumors were reclassified as benign; ER⁺ and CK5/6⁻ tumors as malignant; p63⁻ tumors as invasive; papillary malignant tumors with a smooth muscle actin (SMA)⁺ fibrovascular core and p63⁻ myoepithelial cells as encapsulated papillary carcinoma; and CD56⁺ carcinomas as neuroendocrine carcinoma. Diagnostic rates were as follows: benign (44% FNAB, 51% CB), atypical (21% FNAB, 3% CB), suspicious of malignancy and malignant (28% FNAB, 40% CB), and insufficient/inadequate (7% FNAB, 6% CB). CB achieved >85% sensitivity, specificity, and positive and negative predictive values. Conclusion: CBs represent 3D FNA cell morphology using 2D sections, enabling adaption of pathology criteria to the cytological material. Immunocytochemical staining of CBs can predict low nuclear grade papillary tumors and reduce atypical case frequency, improving diagnostic accuracy.

Breast fine-needle aspiration cytology reporting using international academy of cytology Yokohama system: A single institution experience

Breast fine-needle aspiration cytology reporting using international academy of cytology Yokohama system: A single institution experience

Validation of the IAC Yokohama system for reporting breast fine-needle aspiration cytology categorization of breast lesions in Vindhya region population

Background: In 2016, International academy of cytology (IAC) has established a standardized approach for reporting breast fine-needle aspiration cytology (FNAC) by categorizing the lesions in five tier system from C1 to C5 to standardize reporting, which will enhance Breast fine-needle aspiration biopsy cytology performance, interpretation, and reporting. Aims and Objectives: The aim of the study was to categorize FNAC cases according to The IAC Yokohama System and evaluate the diagnostic ability of FNAC. Materials and Methods: The current prospective analytical study was carried out in the Department of Pathology, Shyam Shah Medical College, Rewa, Madhya Pradesh, for a period of 15 months from January 2021 to March 2022 (15 months). A total of 100 cases were included in the study based on inclusion criteria. The results were analyzed based on cytological reporting and P value calculated. Results: Among the 100 cases studied highest number of cases were from the age group of 21–30 years with 29% (n=29). The most common breast laterality affected was left with 69% of affected cases. The maximum number of cases, 69% (n=69) of the total, were found to be categorized under the category C2 (benign) which was followed by Category C5 (Malignant) seen in 13% (n=13). About 9% (n=9) of the total cases were categorized as suspicious of malignancy (C4). Atypical Lesion (C3) and Unsatisfactory Lesions (C1) were categorized in 5% (n=5) and 4% (n=4) of the total cases, respectively. Conclusion: FNAC is a minimally invasive, quick, and efficient pre-operative diagnostic tool that can also be used for postoperative breast lump follow-up to prevent recurrences. FNAC using IAC Yokohama system is a rapid and effective method for the primary categorization of palpable breast lumps and provides better clarity to the clinicians in the management of the patient and can reduce unnecessary surgeries.

Cytomorphological overview of fine-needle aspiration breast utilizing the International Academy of Cytology – Yokohama system of reporting

Background: Benign and malignant lesions of breast are one of the most common causes of palpable masses seen in women. Fine-needle aspiration cytology (FNAC) is the important modality of diagnosis of breast lumps. Previously, there were no uniform criteria for reporting breast FNAC. To overcome this problem, the newly designed system – International Academy of Cytology (IAC) – Yokohama system of reporting was implemented in 2016. The system offers a structured report to the patient. Aims and Objectives: This study aims to categorize breast FNAC according to the IAC – Yokohama system of reporting, to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the test, and to analyze the cytomorphological spectrum of various breast lesions. Materials and Methods: A total of 210 patients presenting with breast lump in cytology section were subjected to FNAC using a 22 gauge needle under all aseptic precautions. Detailed clinical history was taken. All cytology and histopathology examination slides (wherever available) were thoroughly studied. FNAC smears were reported using IAC – Yokohama system of reporting. Results: In our study, benign category (C2) was most commonly seen in 73.33% of cases, followed by 10.48% of cases of atypical probably benign (C3), 2.38% of cases were reported as suspicious (C4), and 11.43% of cases were reported as malignant (C5). Cytohistopathological concordance was seen in 38 cases (88.4%) whereas five cases were reported as discordant. Sensitivity and specificity of the test for the diagnosis of malignancy were 81% and 100%, respectively. PPV was 100%. NPV was 90.90%. Diagnostic accuracy of the test was 93.47%. Conclusion: The newer IAC – Yokohama system of reporting of breast FNAC is simple, has clear diagnostic criteria hence boost up the confidence as well has uniformity of reporting by cytopathologist, and increases the understanding and uniformity in assessment by the attending clinician which help in improving the communication between the pathologist and the treating clinician.

A review of the predictive values and malignancy risks of the YOKOHAMA system for reporting breast fine needle aspiration cytology

A review of the predictive values and malignancy risks of the YOKOHAMA system for reporting breast fine needle aspiration cytology

Evaluation of Breast, Lymph Node, and Thyroid Fine Needle Aspiration Cytology by Liquid Based Smears and Conventional Smears

Introduction: Fine needle aspiration cytology (FNAC) is a first-line investigation for palpable lumps and is a highly cost-effective and accurate investigative technique. It is a safe, simple, rapid, minimally invasive technique. Liquid-based cytology (LBC) has been used in gynecologic-cytology for over three decades. Many laboratories have adopted LBC technique for exfoliative and FNA samples. We undertook the present study to compare the advantages and disadvantages of conventional and liquid based cytology preparations. Aim of the study: To evaluate the diagnostic accuracy of LBC and Conventional smears in fine needle aspiration cytology samples from breast, lymph nodes, and thyroid tissue. Materials and methods: FNA material from accessible sites such as palpable breast lumps, thyroid, and lymph nodes were collected from 100 patients and was processed by two different methods, i.e., Conventional smears and by LBC. Various parameters on the slides were considered and compared for both the preparations. Out of 100 FNA samples, 51% were of Thyroid, 34% were of lymph node and 15% were of breast lumps. Observations and results: Adequate cellularity and better architecture was present in conventional smears than LBC preparations. Background material was less, and monolayers were better in the LBC preparations. Informative background material (i.e. Colloid, lymphoglandular bodies, etc) was more in cases of Conventional smears. The nuclear and cytoplasmic details were nearly equally good in both the preparations. Conclusion: Both these methods have their own advantages and disadvantages. Before incorporating LBC as a routine method, pathologists should familiarize themselves with all the aspects of LBC.

Mean Micronuclei Score in Fine-Needle Aspiration Cytology of Patients with Malignant Breast Lump in the Department of Pathology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Micronucleus is used as a biomarker of chromosomal instability, which is one of the hallmarks of neoplastic transformation. As micronuclei score increases with malignancy, it can be an effective and inexpensive adjunct to breast fine needle aspiration cytology, in diagnosing breast lumps, especially detecting grey lesions between benign and malignant tumours. The aim of this study is to find out the mean micronuclei score in fine-needle aspiration cytology of patients with malignant breast lumps in the Department of Pathology in a tertiary care centre. A descriptive cross-sectional study was conducted among patients with malignant breast lumps in the Department of Pathology in a tertiary care centre between 1 May 2020 to 31 May 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: IRC/2139/021). The fine-needle aspiration cytology of breast lumps was diagnosed as per National Health services breast screening program guidelines. The mean micronuclei score was calculated. Convenience sampling was done and data were collected from the hospital records in the Department. Point estimate and 95% Confidence Interval were calculated. Among 20 malignant breast aspirates, the mean micronuclei score was found to be 8.30±3.75 (3-19, 95% Confidence Interval). The mean micronuclei score in fine-needle aspiration cytology of malignant breast lumps was found to be similar when compared to similar studies conducted in similar settings. biomarker; breast neoplasm; chromosomal instability; fine-needle aspiration.

Neither Russell nor Magenta bodies: A cytological dilemma in breast fine needle aspiration cytology.

Neuroendocrine neoplasms (NENs) are a rare heterogeneous group of breast epithelial tumours showing predominant NE differentiation. NENs of the breast account for less than 1% of all NENs. The index case calls for recognition of these tumours using morphology adjunct with ancillary techniques such as immunohistochemistry on FNA cell blocks.

Evaluation of Cytomorphological Patterns of Fibroadenoma on Cytology: Emphasis on Pattern based approach to avoid misdiagnosis

Background: Fibroadenoma (FA) is a frequently occurring breast lesion diagnosed on fine needle aspiration cytology (FNAC) with a bimodal picture comprising of epithelial and/or stromal component. It can have a gamut of differential diagnosis depending on the predominant cellular features reflected on cytological smears, thereby it is important that the cytologist should be well versed with the various patterns of fibroadenoma to avoid diagnostic errors. Materials and methods: The present study was conducted over a period of two years including all cases of fibroadenoma diagnosed on cytology (n=234). The detailed cytomorphological spectrum was analysed to study the different patterns of fibroadenoma on cytology. Out of these (234), cytohistological correlation was performed in 197 cases. Results: The incidence of fibroadenoma among all the breast FNACs was 50% (234/468). The different patterns observed were: epithelial predominant, stromal predominant, FA with giant cells, apocrine change, cyst macrophages, granuloma, acute inflammation and atypia. Cytohistologic concordance was observed in 173/197 cases (87.8%). Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 98.8%, 92.3%, 87.8%, 94.5% and 88.8% respectively. Conclusion: Although fibroadenoma can be diagnosed with ease on cytology in most of the cases, However, at times in addition to classical features, morphological variations are observed such as giant cells, cyst macrophages, apocrine change, granulomas, acute inflammation and atypia wherein it maybe misdiagnosed as benign phyllodes, hyperplasia, fibrocystic disease etc.. This pattern based approach for the cytological diagnosis of FA is re-emphasized in the index article so as to create awareness about these varied patterns among the young cytopathologists. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 590-595

A Study of Fine Needle Aspiration Cytology of Breast Lesions in Females with Special Reference to IAC Standardized Reporting at a Tertiary Care Centre

Background: Carcinoma of the breast is one of commonest carcinomas found in Indian women and also around the world. Fine Needle Aspiration Cytology (FNAC), a quick, cost effective and patient compliant procedure, can give an adequate diagnosis to rule out at best the difference between a benign and malignant breast lump. The International Academy of Cytology (IAC) has developed a process for Fine-Needle Aspiration Cytology (FNAC) reporting that is thorough and standardized. C1 to C5 are the categories for breast lesions. Methods: A total of 166 breast FNACs were performed over a period of 2.5 years after fulfilling the inclusion and exclusion criteria and the aspirates were stained by Hematoxylin and Eosin stains and the stained slides were studied and diagnosis was made accordingly. The patients were classified using the IAC classification system that relies on their cytomorphological characteristics. Results: Out of 166 cases, 136 were neoplastic, 6 non-neoplastic and 24 cases were inadequate to opine. Of the 136 neoplastic cases, 89 cases (53.61%) were diagnosed as fibroadenoma and 19 cases (11.44%) were diagnosed as duct carcinoma. Conclusion: The fine needle aspiration cytology is a critical diagnostic tool in the management of patients with breast lump. It is an easy, reliable, patient friendly, repeatable and simple diagnostic test. FNAC can have a very high diagnostic accuracy when performed by experts.

ANALYSE AND CLASSIFY VARIOUS BREAST LESIONS ON FNAC WITH SPECIAL REFERENCE TO IAC STANDARDISED REPORTING SYSTEM: A RETROSPECTIVE ANALYSIS OF 300 CASES

Introduction: Breast lumps are the common manifestations in clinical practice. For uniform reporting, better diagnostic clarity and uniform patient management International Academy of Cytology (IAC) has classified reporting of breast Fine needle aspiration cytology (FNAC) into 5 tier yokohama reporting system (C1 to C5). Material and Methods: Present study is a retrospective study done in Department of Pathology, GSVM medical college, Kanpur over a period of 12 month (December 2020 to November 2021). Total 300 cases of FNAC breast smears were reviewed and classified according to IAC reporting system (C1 to C5). Results: In our study we had total 300 cases in 12 month period with female patients (285) out numbered male patients (15). On age wise distribution we get maximum no of cases in 2nd and 3rd decade. On categorization of breast lesions according to IAC Yokohama reporting system out of total 300 cases we get C1 lesions in 09(3.0%)cases , C2 lesions in 184(61.3%) cases, C3 lesions in 26(8.6%) cases, C4 lesions in 11(3.6%) cases and C5 lesions in 70(23.3%) cases. Conclusion: Use of FNAC method for evaluation of breast lump for preoperative management is quick, simple and cost effective, with IAC reporting system we can uniformily classify breast FNA cytology for better patient management and better guidance to clinician.

Application of International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Cytology- A Retrospective Study

Introduction: Fine Needle Aspiration Cytology (FNAC) is a rapid, minimally invasive and cost-effective procedure with a high sensitivity rate of 92-95% and high Positive Predictive Value (PPV) approaching 100% for the diagnosis of breast malignancies. International Academy of Cytology (IAC) Yokohama system for reporting breast FNACs had been established in 2016 to bring consistency and uniformity of breast cytology reporting. Aim: To classify the breast lesions according to the IAC Yokohama system for cytological reporting of breast lesions. Materials and Methods: This was a retrospective six years study carried out in the Department of Pathology, Karpaga Vinayaga Institute of Medical Sciences, Chinnakolambakkam, Tamil Nadu, India. All females breast FNAC cases reported during the year January 2015 to December 2020 were included in the study according to the inclusion criteria. Relevant clinical and pathological data including the FNAC reports were retrieved from the medical records of the department. Corresponding FNAC smears stained with Haematoxylin and Eosin (H&E) and Papanicolaou stains were reviewed and double-checked with the FNAC reports. All those cases were grouped according to the IAC Yokohama System. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Of the total 381 female breast FNACs, majority (60%) of them belonged to the age group of 21-40 years. The predominant presenting symptom was palpable breast lump (73%) and Upper Outer Quadrant (UOQ) was involved in 65% of cases. Out of 381 cases, 297 (78%) were benign, 52 (13.6%) were malignant and 32 (8.4%) were inadequate for diagnosis. Total 73.8% cases belonged to “C2” category and fibroadenoma was the most prevalent lesion. Pearson Chi-square test showed highly significant association between patient’s age above 40 years and the risk of having a malignant breast lesion (p<0.0001). Conclusion: FNAC is an effective diagnostic modality for preoperative diagnosis of breast lesions thereby facilitating proper treatment at an early stage of the disease. Also adherence to the standardised cytological reporting system like IAC Yokohama system will ensure quality assurance across various institutions, thereby strengthening the healthcare services.

Triple Assessment for the Diagnosis of Carcinoma Breast in a Tertiary Care Hospital of Tripura: A Cross-sectional Study

Introduction: A combination of invasive and non-invasive procedures, clinical examination, radiological imaging (mammography/ ultrasonography/ Magnetic Resonance Imaging (MRI)) and fine needle aspiration cytology called the triple assessment test is being increasingly used in place of the more invasive core needle biopsy and histopathology. Aim: To evaluate accuracy of triple assessment in the preoperative diagnosis of patients with breast carcinoma and to determine sensitivity and specificity with regards to histopathology in the diagnosis of the disease. Materials and Methods: A cross-sectional study was conducted among 61 women of more than 25 years of age having palpable breast lump, attending the surgery Outpatient Department (OPD) and breast clinic of a tertiary care hospital from January 2017 to February 2019. Data on socio-demographic status, menstrual and obstetric information, clinical examination performed, mammography, Fine Needle Aspiration Cytology (FNAC), High resolution sonography breast and histopathology were recorded into predesigned and pretested proformas and analyzed using Statistical Package for Social Sciences (SPSS) version 25.0. Results: Out of total 61 patients participated in the present study, most patients were of 41-50 years of age, with a mean age of 44.23±7.37 years, married, non-vegetarian and without any past history of alcohol consumption. Sensitivity and specificity of triple assessment was 98.3% and 100% respectively. The positive predictive value of Triple Assessment was 100% while the negative predictive value was 66.7%. All values were significantly better than both clinical breast examination and FNAC in detecting malignancies. Conclusion: The triple test was also found to be as accurate in diagnosing breast carcinoma in this geographical region. A patient with a negative triple test report can be safely followed up without the need for biopsy.

Genç Bir Erkekte Semptomatik Benign Meme Kisti

Simple breast cysts are benign lesions diagnosed in premenopausal women commonly presenting with a palpable breast lump. They are however, extremely rare in males due to the absence of lobular tissue in the male breast. We report a case of a benign breast cyst in a 19-year-old male who presented with a left breast lump and nipple discharge. Clinical examination revealed a non-tender 2x2 cm mobile retro-areolar lump in the left breast with clear serous nipple discharge upon milking of the duct. Ultrasonography showed typical features suggestive of a simple breast cyst and fine needle aspiration cytology revealed epithelial cells of apocrine origin, thus confirming the diagnosis. We review the literature and discuss the approach to investigation of these uncommon lesions presented in males.

How Accurately FNAC Reflects the Breast Papillary Lesions?

Context:Diagnosis of papillary lesions of the breast by fine needle aspiration cytology (FNAC) is problematic. For this reason, it is situated in the indeterminate zone in classification systems.Aims:To ascertain the accuracy of cytological diagnosis of papillary lesions in distinguishing papillary lesions from non-papillary lesions and to determine whether papillomas can be reliably distinguished from malignant papillary lesions by FNAC.Material and Methods:A total of 346 cases with the diagnoses of breast papillary lesions were selected among 5112 breast FNAC procedures performed in our center. One hundred and thirty-nine cases with excised lesions were included in this study, and their corresponding histology was reviewed.Results:Papillary lesion diagnosis was confirmed by histopathology in 103 (74.1%) of 139 patients. Cytology and histopathology results were not found to be compatible in 35 (25.2%) cases. The diagnostic accuracy of distinguishing papillary breast lesions as malignant or benign was assessed statistically. According to the cytology–histology comparison, one case was evaluated as false negative (FN) and twelve cases as false positive (FP). Overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC in distinguishing papillary lesions as benign or malignant were calculated as 87%, 97%, 83%, 72%, and 98%, respectively.Conclusions:The diagnostic accuracy of papillary breast lesions classified by FNAC might be improved by careful evaluation together with cytological, radiological, and clinical findings (triple test). Cell block may allow more accurate evaluation of the papillary lesion and can be applied to immunohistochemical examination. It may also facilitate the differentiation of benign/malignant papillary lesions.