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Zhu L, Zeng X, Jiang S, Ruan S, Ma H, Li Y, Ye C, Dong J. Prevalence of breast fibroadenoma in healthy physical examination population in Guangdong province of China: a cross-sectional study. BMJ Open 2022; 12:e057080. [PMID: 35760543 PMCID: PMC9237909 DOI: 10.1136/bmjopen-2021-057080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To provide an accurate assessment of the prevalence of breast fibroadenoma in a large population and to confirm the diagnostic accuracy of ultrasound for fibroadenoma. DESIGN This was a cross-sectional survey. SETTING This research was conducted at Nanfang Hospital, Guangzhou, Guangdong, China. PARTICIPANTS A total of 11 898 women aged 18-40 years who underwent breast screening between 1 January 2019 and 31 December 2019 were included in the fibroadenoma prevalence study. From 1 June 2019 to 31 December 2019, 342 breast lesions with pathology reports and preoperative ultrasound images were collected for diagnostic fibroadenoma testing (vs histological diagnostic testing). PRIMARY OUTCOME MEASURES Pearson's χ2 test was performed to compare the prevalence of different lesions between age groups, and descriptive statistics were used to report the clinical characteristics of fibroadenoma. For ultrasound diagnosis, fibroadenoma was defined as a well-circumscribed lesion with round or oval shape, consisting of a homogeneously hypoechoic or isoechoic solid mass, located parallel to the chest wall with a smooth margin and no posterior shadowing. Diagnostic test results for breast fibroadenoma were stratified by diagnostic type (histological vs ultrasound). RESULTS Of the women aged 18-40 years, 27.6% (3285/11 898) had an ultrasound diagnosis offibroadenoma. Of these, the prevalence of fibroadenoma was stable across age groups (p=0.14) and did not differ between the left and right sides of the breast. Almost two-thirds of women presented with a single fibroadenoma, and most fibroadenomas did not exceed 1 cm in size. The sensitivity and specificity for fibroadenoma were 97.0% (95% CI for sensitivity: 93.7% to 98.8%) and 91.4% (95% CI for specificity: 85.4% to 95.5%) for ultrasonography, respectively. CONCLUSIONS The prevalence of fibroadenoma in South China is as high as 27.6%, and ultrasound could be used as a tool to diagnose fibroadenoma.
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Affiliation(s)
- Lijun Zhu
- Department of Medicine Ultrasonics, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Xiaoqi Zeng
- Breast Center, Department of general surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Shanshan Jiang
- Institute of Hematological Research, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Simin Ruan
- Breast Center, Department of general surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Huanrong Ma
- Department of Medicine Ultrasonics, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Yingjia Li
- Department of Medicine Ultrasonics, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Changsheng Ye
- Breast Center, Department of general surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Jianyu Dong
- Breast Center, Department of general surgery, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
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Rana C, Kamal N, Mishra P, Singh A, Ramakant P, Mishra A, Singh K. Cellular fibroadenoma versus phyllodes tumors: A pre‐operative diagnostic approach based on radiological and cytological features. Diagn Cytopathol 2022; 50:375-385. [DOI: 10.1002/dc.24965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/11/2022] [Accepted: 04/05/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Chanchal Rana
- Department of Pathology King George's Medical University Lucknow India
| | - Nidhi Kamal
- Department of Pathology King George's Medical University Lucknow India
| | - Prabhakar Mishra
- Department of Biostatistics and Health Informatics Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow India
| | - Akanksha Singh
- Department of Pathology King George's Medical University Lucknow India
| | - Pooja Ramakant
- Department of Endocrine Surgery King George's Medical University Lucknow India
| | - Anand Mishra
- Department of Endocrine Surgery King George's Medical University Lucknow India
| | - Kulranjan Singh
- Department of Endocrine Surgery King George's Medical University Lucknow India
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Agrawal S, Anthony ML, Paul P, Singh D, Agarwal A, Mehan A, Singh A, Joshi PP, Kumar A, Syed A, Ravi B, Rao S, Chowdhury N. Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy. Acta Cytol 2021; 65:220-226. [PMID: 33906188 DOI: 10.1159/000515914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. MATERIALS AND METHODS FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calculated for each BIRADS 4a, 4b, and 4c subgroup. RESULTS A total of 249 cases of BIRADS 4 lesions had corresponding cytology and histopathology diagnoses. FNAB showed high diagnostic accuracy in all BIRADS groups. A benign categorization was associated with a very low number of false-negative diagnoses, especially in BIRADS 4a lesions. CONCLUSION The study reconfirms the excellent accuracy of breast FNAB using the IAC Yokohama system in diagnosing breast malignancies. Furthermore, BIRADS 4a lesions found to be belonging to the cytological benign category may be excluded from CRB and kept on clinical follow-up.
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Affiliation(s)
- Shruti Agrawal
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India,
| | | | - Pranoy Paul
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Divya Singh
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Akansha Agarwal
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Anoushika Mehan
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | | | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Anjum Syed
- Integrated Breast Care Centre and Department of Radiodiagnosis, AIIMS, Rishikesh, India
| | - Bina Ravi
- Integrated Breast Care Centre and Department of Surgery, AIIMS, Rishikesh, India
| | - Shalinee Rao
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, AIIMS, Rishikesh, India
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Agrawal S, Anthony ML, Paul P, Singh D, Mehan A, Singh A, Joshi PP, Kumar A, Syed A, Ravi B, Rao S, Chowdhury N. Prospective evaluation of accuracy of fine-needle aspiration biopsy for breast lesions using the International Academy of Cytology Yokohama System for reporting breast cytopathology. Diagn Cytopathol 2021; 49:805-810. [PMID: 33755356 DOI: 10.1002/dc.24743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Classification of breast lesions into different cytological groups can accurately be done using the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology. Fine needle aspiration biopsy (FNAB) of breast lesions has been considered to be the primary investigation in detecting breast cancers, especially in low-cost settings. The main objective of this study was to prospectively re-confirm the diagnostic accuracy of breast FNAB using the IAC Yokohama system. Additionally, separate secondary subgroup analysis was done to confirm the accuracy of breast FNAB excluding lymph-node positive and lymphadenopathy positive tumors. MATERIAL AND METHODS A prospective study was done on patients undergoing biopsy of breast lesions between September 01, 2019 and November 30, 2020 (519 biopsies on 487 unique patients). Of these 519 histopathology biopsies, 505 had corresponding FNAB report of the same site. The FNAB was reported using the IAC Yokohama system and the most suitable category was allotted in every case. The rates of malignancy for each category and the accuracy of breast FNAB in diagnosing malignancy were calculated. RESULTS Of the total 487 patients, 120 cases were benign on histology, while 367 were malignant. The rates of malignancy in benign, atypical, suspicious and malignant categories were 5%, 25%, 71%, and 99.7%, respectively. The diagnostic accuracy of atypical, suspicious and malignant categories was calculated as 90.1%, 95.2%, and 93.3%, respectively. CONCLUSION The high diagnostic accuracy for each BIRADS category suggest excellent accuracy for Breast FNAB using the IAC Yokohama system.
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Affiliation(s)
- Shruti Agrawal
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Michael Leonard Anthony
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Pranoy Paul
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Divya Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Anoushika Mehan
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Ashok Singh
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Prashant Pranesh Joshi
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Anjum Syed
- Integrated Breast Care Centre, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bina Ravi
- Integrated Breast Care Centre, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shalinee Rao
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Science, Rishikesh, Uttarkhand, India
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Agarwal A, Singh D, Mehan A, Paul P, Puri N, Gupta P, Syed A, Rao S, Chowdhury N, Ravi B. Accuracy of the International Academy of Cytology Yokohama system of breast cytology reporting for fine needle aspiration biopsy of the breast in a dedicated breast care setting. Diagn Cytopathol 2020; 49:195-202. [PMID: 33017520 DOI: 10.1002/dc.24632] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND The International Academy of Cytology (IAC) Yokohama system is a recently proposed system for reporting breast cytology by fine needle aspiration biopsies (FNAB). Multiple studies are needed to confirm the risk of malignancy (ROM) of the various reporting categories of this system. The present article studies the accuracy of the IAC Yokohama system in our center. METHODS Over a period of 1 year (September 2018-August 2019), all cases of breast masses assessed by FNAB and histological correlation were studied retrospectively. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) and overall accuracy of the IAC Yokohama system for diagnosing malignancy were assessed. The rates of malignancy (ROM) of each diagnostic category were also estimated. RESULTS Three hundred and twenty-one FNABs had cyto-histological correlation. The percent sensitivity (with 95% Confidence Intervals) when the atypical, suspicious of malignancy and the malignant categories were regarded as positive for malignancy were 98.2% [95.5%, 99.5%], 96.0% [92.5%, 98.2%], and 86.7% [81.5%, 90.8%] respectively. The percent specificity (with 95% Confidence intervals) for the same categories in the same order were 59.5% [47.4%, 70.7%], 91.9% [83.2%, 97.0%], and 100% [95.1%, 100%] respectively. The area under curve (AUC) for diagnosing malignancy was 0.981[0.963, 0.993]. The ROM for the benign, atypical, suspicious of malignancy and malignant category were 8.3% [2.3%, 20.0%], 17.2% [5.8%, 35.8%], 77.8% [57.7%, 91.4%], and 100% [98.1%, 100%] respectively. CONCLUSION The IAC Yokohama system is suitable for accurately reporting breast lesions on FNAB.
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Affiliation(s)
- Akansha Agarwal
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Divya Singh
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Anoushika Mehan
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Pranoy Paul
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Neeti Puri
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Priyanka Gupta
- Integrated Breast Care Centre and Department of radiodiagnosis, All India Institute of Medical Sciences, , Rishikesh, India
| | - Anjum Syed
- Integrated Breast Care Centre and Department of radiodiagnosis, All India Institute of Medical Sciences, , Rishikesh, India
| | - Shalinee Rao
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Integrated Breast Care Centre and Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Bina Ravi
- Integrated Breast Care Centre and Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
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