RAPID ON-SITE EVALUATION AND MICRONUCLEUS SCORING IN BREAST LESIONS FINE NEEDLE ASPIRATION CYTOPATHOLOGY BY NEW IAC YOKOHAMA SYSTEM OF REPORTING

SAMRITI GOYAL; MOHANVIR KAUR; KANWARDEEP KAUR; ROMMEL SINGH MOHI

doi:10.22159/ajpcr.2024.v17i4.47786

Authors

SAMRITI GOYAL Department of Pathology, GMC, Patiala, Punjab, India
MOHANVIR KAUR Department of Pathology, GMC, Patiala, Punjab, India
KANWARDEEP KAUR Department of Pathology, GMC, Patiala, Punjab, India
ROMMEL SINGH MOHI Department of Pathology, GMC, Patiala, Punjab, India

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i4.47786

Keywords:

Rapid onsite evaluation, Micronucleus, Fine needle aspiration cytology, Yokohama

Abstract

Objective: The objective of the study is to report all fine needle aspiration cytopathology (FNAC) cases of lump breast as per New Yokohama classification 2016, to highlight the importance of rapid onsite evaluation (ROSE) in breast cytology at the time of FNAC, and to assess the relationship between micronucleus (MN) scoring and various breast lesions in cytology.

Methods: The study was conducted on 70 patients with breast lumps in the Department of Pathology in Government Medical College, Patiala, and comprised evaluation of ROSE and MN scoring in breast FNAC by the use of New Yokohama system of reporting.

Results: On ROSE, 11 out of 70 patients were categorized under category I according to the Yokohama system of reporting and on the same sitting with repeat FNAC after performing the ROSE; nine cases were upgraded for cytological reporting and two remained in category I. According to as per the International Academy of Cytology (IAC) Yokohama system of reporting (2016) cases were categorized as category I – 2 (2.9%), category II – 46 (65.7%), category III – 7 (10.1%), category IV – 5 (7.1%), and category V – 10 (14.2%). In MN scoring, MN with the highest score of 14–17/1000 epithelial cells was in category V (malignant), and the lowest score was 0–1/1000 epithelial cells in category II (benign).

Conclusion: ROSE is an easy, safe, and cost-effective method. IAC Yokohama system for reporting (2016) provides a comprehensive way of categorizing various breast lesions on FNAC with clinical correlation. MN score is a good biomarker in differentiating benign, atypical, and malignant breast lesions.

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References

Yogalakshmi S, Kavitha M. A study of histopathological spectrum of breast lesions. Int J Sci Stud. 2019;7(1):1-5.

Field AS, Raymond WA, Rickard M, Arnold L, Brachtel EF, Chaiwun B, et al. The international academy of cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Acta Cytol. 2019;63(4):257-73. doi: 10.1159/000499509, PMID 31112942

Field AS, Schmitt F, Vielh P. IAC Standardized reporting of breast fine-needle aspiration biopsy cytology. Acta Cytol. 2017;61(1):3-6. doi: 10.1159/000450880, PMID 27806362

Sommer S, Buraczewska I, Kruszewski M. Micronucleus assay: The state of art, and future directions. Int J Mol Sci. 2020 Feb 24;21(4):1534. doi: 10.3390/ijms21041534, PMID 32102335

Fenech M, Holland N, Zeiger E, Chang WP, Burgaz S, Thomas P, et al. The HUMN and HUMNxL international collaboration projects on human micronucleus assays in lymphocytes and buccal cells--past, present and future. Mutagenesis. 2011;26(1):239-45. doi: 10.1093/ mutage/geq051, PMID 21164208

Holland N, Bolognesi C, Kirsch-Volders M, Bonassi S, Zeiger E, Knasmueller S, et al. The micronucleus assay in human buccal cells as a tool for biomonitoring DNA damage: The HUMN project perspective on current status and knowledge gaps. Mutat Res. 2008 Jul- Aug;659(1-2):93-108. doi: 10.1016/j.mrrev.2008.03.007, PMID 18514568

Fenech M, Holland N, Chang WP, Zeiger E, Bonassi S. The HUman MicroNucleus Project--An international collaborative study on the use of the micronucleus technique for measuring DNA damage in humans. Mutat Res. 1999;428(1-2):271-83. doi: 10.1016/s1383-5742(99)00053-8, PMID 10517999

Sylvia MT, Baskaran L, Bhat RV. Micronucleus study on breast cytology aspirate smears and its diagnostic utility. J Cytol. 2018;35(1):22-6. doi: 10.4103/JOC.JOC_160_16, PMID 29403165

Wong S, Rickard M, Earls P, Arnold L, Bako B, Field AS. The International Academy of Cytology Yokohama System for reporting breast fine needle aspiration biopsy cytopathology: A single institutional retrospective study of the application of the system categories and the impact of rapid onsite evaluation. Acta Cytol. 2019;63(4):280-91. doi: 10.1159/000500191, PMID 31108486

Schmidt RL, Witt BL, Lopez-Calderon LE, Layfield LJ. The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology: A systematic review and meta-analysis. Am J Clin Pathol. 2013;139:300-8.

Samanta S, Dey P, Nijhawan R. The role of micronucleus scoring in fine needle aspirates of ductal carcinoma of the breast. Cytopathology. 2011 Apr;22(2):111-4. doi: 10.1111/j.1365-2303.2010.00773.x, PMID 20553316

Liew PL, Liu TJ, Hsieh MC, Lin HP, Lu CF, Yao MS, et al. Rapid staining and immediate interpretation of fine-needle aspiration cytology for palpable breast lesions: Diagnostic accuracy, mammographic, ultrasonographic and histopathologic correlations. Acta Cytol. 2011;55(1):30-7. doi: 10.1159/000320869, PMID 21135519

Ibikunle DE, Omotayo JA, Ariyibi OO. Fine needle aspiration cytology of breast lumps with histopathologic correlation in Owo, Ondo State, Nigeria: A five-year review. Ghana Med J. 2017;51(1):1-5. doi: 10.4314/gmj.v51i1.1, PMID 28959065

Montezuma D, Malheiros D, Schmitt FC. Breast fine needle aspiration biopsy cytology using the newly proposed IAC Yokohama system for reporting breast cytopathology: The experience of a single institution. Acta Cytol. 2019 Feb 15; 1:1-6. doi: 10.1159/000492638, PMID 30783035

Chauhan V, Pujani M, Agarwal C, Chandoke RK, Raychaudhuri S, Singh K, et al. IAC standardized reporting of breast fine-needle aspiration cytology, Yokohama 2016: A critical appraisal over a 2 year period. Breast Dis. 2019;38(3-4):109-15. doi: 10.3233/BD-190393, PMID 31524134

Agrawal N, Kothari K, Tummidi S, Sood P, Agnihotri M, Shah V. Fine-needle aspiration biopsy cytopathology of breast lesions using the international academy of cytology Yokohama system and rapid on-site evaluation: A single-institute experience. Acta Cytol. 2021;65(6):463-77. doi: 10.1159/000518375, PMID 34515039

Dixit N, Trivedi S, Bansal VK. A retrospective analysis of 512 cases of breast fine needle aspiration cytology utilizing the recently proposed IAC Yokohama system for reporting breast cytopathology. Diagn Cytopathol. 2021 Sep;49(9):1022-31. doi: 10.1002/dc.24808, PMID 34133084

Hemalatha A, Suresh TN, HarendraKumar ML. Micronuclei in breast aspirates. Is scoring them helpful? J Cancer Res Ther. 2014 Apr-Jun;10(2):309-11. doi: 10.4103/0973-1482.136588, PMID 25022383

Katta R, Rao KN, Murthy BK, Kalam SR. Micronucleus scoring in fine needle aspiration cytology of breast lesions-a retrospective analytical study. J Clin Diagn Res. 2022 Aug;16(8):EC52-5.