Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings

Objective: Breast cancer is the most prevalent cancer among women worldwide. In developing countries, fine needle aspiration cytology (FNAC) is commonly used for screening to reduce mortality rates. The International Academy of Cytology has established the Yokohama system to enhance diagnostic clari...

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Main Authors: Vishal Rohilla, Parveen Kundu, Monika Gathwal, Pushpendra Malik, Chiranjeev Gathwal, Sunaina Hooda
Format: Article
Language:English
Published: Galenos Publishing House 2025-07-01
Series:European Journal of Breast Health
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Online Access:https://www.eurjbreasthealth.com/articles/categorization-of-breast-fine-needle-aspirates-using-yokohama-classification-and-its-correlation-with-histopathological-findings/doi/ejbh.galenos.2025.2024-11-4
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author Vishal Rohilla
Parveen Kundu
Monika Gathwal
Pushpendra Malik
Chiranjeev Gathwal
Sunaina Hooda
author_facet Vishal Rohilla
Parveen Kundu
Monika Gathwal
Pushpendra Malik
Chiranjeev Gathwal
Sunaina Hooda
author_sort Vishal Rohilla
collection DOAJ
description Objective: Breast cancer is the most prevalent cancer among women worldwide. In developing countries, fine needle aspiration cytology (FNAC) is commonly used for screening to reduce mortality rates. The International Academy of Cytology has established the Yokohama system to enhance diagnostic clarity and communication between pathologists and clinicians. A triple test approach, incorporating clinical evaluation, imaging, and FNAC, can further improve patient care for breast lesions and may enhance the Yokohama System’s effectiveness. Materials and Methods: A prospective study about breast FNAC was done over a period of one year, from October 2022 to September 2023. The study involved patients with breast lesion referred for FNAC in the department of Pathology. The FNAC results were further classified using the Yokohama system for reporting breast cytopathology, 2016. The cytological findings were correlated with available histopathological results. Results: In the study of 104 cases, 60 (57.7%) of whom had available histopathology results, breast lesions were categorized using the Yokohama system as: 7.7% insufficient, 47.1% benign, 26.9% atypical, 2.9% suspicious of malignancy, and 15.4% malignant. The risk of malignancy varied by category: 0% for category 1, 3.2% for category 2, 47% for category 3, and 100% for categories 4 and 5. The maximum sensitivity was 94.7% when considering atypical, suspicious, and malignant cases as positive. The highest specificity was 97.56% for malignant cases alone, while the best diagnostic accuracy was 83.3% when both malignant and suspicious cases were counted as positive. Conclusion: The Yokohama system effectively classified borderline lesions, facilitating early detection and improved management options. By integrating FNAC with standardized reporting, healthcare providers can make informed decisions, enhancing the diagnosis and treatment of breast lesions.
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spelling doaj-art-e92a5ba638d446ee95ef59bca1a1a0172025-08-20T03:30:14ZengGalenos Publishing HouseEuropean Journal of Breast Health2587-08312025-07-0121323724510.4274/ejbh.galenos.2025.2024-11-4Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological FindingsVishal Rohilla0https://orcid.org/0009-0004-9195-7373Parveen Kundu1https://orcid.org/0009-0003-0338-0897Monika Gathwal2https://orcid.org/0000-0001-8806-6554Pushpendra Malik3https://orcid.org/0000-0002-9414-8596Chiranjeev Gathwal4https://orcid.org/0000-0001-9085-0911Sunaina Hooda5https://orcid.org/0009-0004-9204-8235Department of Pathology, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaDepartment of Pathology, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaDepartment of Pathology, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaDepartment of General Surgery, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaDepartment of Radiodiagnosis, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaDepartment of Pathology, Bhagat Phool Singh Government Medical College for Women, Haryana, IndiaObjective: Breast cancer is the most prevalent cancer among women worldwide. In developing countries, fine needle aspiration cytology (FNAC) is commonly used for screening to reduce mortality rates. The International Academy of Cytology has established the Yokohama system to enhance diagnostic clarity and communication between pathologists and clinicians. A triple test approach, incorporating clinical evaluation, imaging, and FNAC, can further improve patient care for breast lesions and may enhance the Yokohama System’s effectiveness. Materials and Methods: A prospective study about breast FNAC was done over a period of one year, from October 2022 to September 2023. The study involved patients with breast lesion referred for FNAC in the department of Pathology. The FNAC results were further classified using the Yokohama system for reporting breast cytopathology, 2016. The cytological findings were correlated with available histopathological results. Results: In the study of 104 cases, 60 (57.7%) of whom had available histopathology results, breast lesions were categorized using the Yokohama system as: 7.7% insufficient, 47.1% benign, 26.9% atypical, 2.9% suspicious of malignancy, and 15.4% malignant. The risk of malignancy varied by category: 0% for category 1, 3.2% for category 2, 47% for category 3, and 100% for categories 4 and 5. The maximum sensitivity was 94.7% when considering atypical, suspicious, and malignant cases as positive. The highest specificity was 97.56% for malignant cases alone, while the best diagnostic accuracy was 83.3% when both malignant and suspicious cases were counted as positive. Conclusion: The Yokohama system effectively classified borderline lesions, facilitating early detection and improved management options. By integrating FNAC with standardized reporting, healthcare providers can make informed decisions, enhancing the diagnosis and treatment of breast lesions.https://www.eurjbreasthealth.com/articles/categorization-of-breast-fine-needle-aspirates-using-yokohama-classification-and-its-correlation-with-histopathological-findings/doi/ejbh.galenos.2025.2024-11-4breast cancerfine needle aspiration cytologyyokohama systemrisk of malignancy
spellingShingle Vishal Rohilla
Parveen Kundu
Monika Gathwal
Pushpendra Malik
Chiranjeev Gathwal
Sunaina Hooda
Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
European Journal of Breast Health
breast cancer
fine needle aspiration cytology
yokohama system
risk of malignancy
title Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
title_full Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
title_fullStr Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
title_full_unstemmed Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
title_short Categorization of Breast Fine Needle Aspirates Using Yokohama Classification and Its Correlation With Histopathological Findings
title_sort categorization of breast fine needle aspirates using yokohama classification and its correlation with histopathological findings
topic breast cancer
fine needle aspiration cytology
yokohama system
risk of malignancy
url https://www.eurjbreasthealth.com/articles/categorization-of-breast-fine-needle-aspirates-using-yokohama-classification-and-its-correlation-with-histopathological-findings/doi/ejbh.galenos.2025.2024-11-4
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