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.
Acta Cytologica

中文翻译：

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使用国际细胞学研究所横滨系统对临床放射学不确定的病变进行乳腺细针穿刺活检的准确性：初步发现证明了低怀疑恶性病变的价值

背景：乳腺病变的细针穿刺活检（FNAB）在区分良性和恶性病变方面提供了准确的结果。然而，何时进行穿刺活检（CNB），其作用尚不清楚，后者可提供有关恶性病变中肿瘤等级，侵袭和激素受体状态的更多信息。在良性乳腺病变中，尤其是在BIRADS 4a和4b类中，FNAB和CNB提供了相似的病理信息，因此FNAB可以作为一种更快速，更具成本效益的研究。计划进行这项研究以重新评估FNAB在BIRADS 4a，4b和4c类病变中的诊断准确性。材料和方法：收集2018年9月1日至2020年11月30日期间发送的所有乳腺病变患者的FNAB和活检报告，并记录每例病例的国际细胞学学会（IAC）横滨类别和BIRADS评分。针对每个BIRADS 4a，4b和4c子组，计算恶性率和FNAB诊断恶性的准确性。结果：共249例BIRADS 4病灶具有相应的细胞学和组织病理学诊断。FNAB在所有BIRADS组中均显示出较高的诊断准确性。良性分类与极少的假阴性诊断相关，尤其是在BIRADS 4a病变中。结论：这项研究再次证实了使用IAC横滨系统对乳房FNAB进行乳房恶性肿瘤诊断的准确性。此外，可以将发现属于细胞学良性类别的BIRADS 4a病变排除在CRB之外，并进行临床随访。
细胞学学报