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An audit of ‘equivocal’ (C3) and ‘suspicious’ (C4) categories in fine needle aspiration cytology of the breast
Author(s) -
Deb R. A.,
Matthews P.,
Elston C. W.,
Ellis I. O.,
Pinder S. E.
Publication year - 2001
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1046/j.1365-2303.2001.00332.x
Subject(s) - medicine , atypia , malignancy , cytology , breast lumps , fibroadenoma , radiology , fine needle aspiration , pathology , breast cancer , biopsy , cancer
An audit of ‘equivocal’ (C3) and ‘suspicious’ (C4) categories in fine needle aspiration cytology of the breast We have audited the frequency of use and outcome of the ‘equivocal/atypia probably benign’ (C3) and ‘suspicious of malignancy’ (C4) category for breast cytology in our Unit. A total of 14 935 cytological specimens were reported by at least one of the three pathologists with a special interest in breast pathology, according to five categories of the NHSBSP guidelines for cytology reporting, 1992; 3.7% (555 cases) and 3.9% (587 cases) of cases were classified as equivocal (C3) and suspicious (C4), respectively, giving a total rate (C3 + C4) of 7.6%. Of the C3 cases, 68% were subsequently benign and 32% were malignant. Of the C4 cases, 19% were subsequently benign and 81% malignant. The commonest benign lesions in both categories were fibroadenomas (7.6% of C3 and 19.8% of C4), fibrocystic change (14.3% of C3 and 12.5% of C4), radial scars (6.2% of C3 and 10.4% of C4) and papillomas (6.2% of C3 and 6.3% of C4). Of the malignant lesions (particularly those classified as C3), a high proportion were low grade or special type cancers. The categories of atypia probably benign (C3) and suspicious of malignancy (C4) in breast cytology provide a strategy for classification of problematic or uncertain cases; this maintains the predictive value of the benign (C2) and malignant (C5) categories, and allows separation of these difficult cases into clinically useful groups with differing probabilities of malignancy.