Breast Fine Needle Aspiration Biopsy Cytology: the potential impact of the International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology and the use of Rapid on Site Evaluation

This article reviews the current problems associated with the routine use of breast fine needle aspiration biopsy (FNAB), and discusses the potential impact that the new International Academy of Cytology (IAC) Yokohama Reporting System and the use of rapid on site evaluation (ROSE), should have on reducing these problems to optimise breast care for patients. The recently published IAC System aims to establish best practice guidelines for breast FNAB, emphasizes the importance of the FNAB technique and the skilful preparation of direct smears, proposes a standardized report, and establishes clear terminology for defined reporting categories each of which has a risk of malignancy and is linked to management options. This article reviews FNAB techniques that will optimize the biopsy and reduce poor quality smears, and discusses the benefits of ROSE. FNAB can diagnose accurately the vast majority of breast lesions, and ROSE is recommended whenever possible to reduce the rate of insufficient/inadequate cases, and increase the number of specific benign and malignant diagnoses. ROSE performed by a cytopathologist provides a provisional diagnosis reducing patient anxiety and facilitating patient management through a cost effective immediate triage and selection for ancillary testing. Patients can be selected for immediate core needle biopsy where required.
Source: Journal of the American Society of Cytopathology - Category: Cytology Source Type: research