Cureus · 2026
Comparative Analysis of the International Academy of Cytology Yokohama System and the Modified Masood Scoring Index in Fine Needle Aspiration Cytology of Palpable Breast Lesions.
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Tripathi Utkarsh, Awasthi Pragati, Rai Tina
Аннотация
INTRODUCTION: Breast cancer has surpassed cervical cancer in India, underscoring the importance of screening and early detection. Triple testing, including clinical examination, mammography, and fine needle aspiration cytology (FNAC), is crucial for assessing suspicious breast lesions. FNAC, a simple and minimally invasive method, effectively diagnoses benign and malignant lesions, aiding treatment, though overlapping morphological features can sometimes cause diagnostic errors.
MATERIALS AND METHODS: This retrospective study involves patients referred for FNAC to the Department of Pathology at Atal Bihari Vajpayee Government Medical College, Vidisha, from February 2023 to July 2024. Cytology slides were retrieved and reviewed by two trained cytopathologists on a single-blind basis, and two commonly used cytological grading systems, i.e., the International Academy of Cytology (IAC) Yokohama Classification and the Modified Masood Scoring Index (MMSI), were applied. Histopathology sections of available breast lesions were reviewed and correlated with cytological diagnoses.
RESULTS: Around 174 (out of a total of 535 fine needle aspirations done) cases of breast lesions were taken into account, for which cytohistopathological examinations were done. They were categorized according to the Yokohama and MMSI systems. Statistical analysis was done using histopathology as the standard.
DISCUSSION: The IAC Yokohama system demonstrated superior diagnostic accuracy, sensitivity, and clinical utility compared to the MMSI. The Yokohama system's risk of malignancy (ROM)-based, five-tiered structure provides clearer management pathways and reduced ambiguity, establishing it as the preferred universal reporting system for routine breast cytopathology.
CONCLUSION: The Yokohama system provides superior diagnostic accuracy, standardized risk stratification, and practical clinical communication compared to the MMSI. Its globally validated, ROM-based framework makes it the preferred, more reliable reporting standard.
MATERIALS AND METHODS: This retrospective study involves patients referred for FNAC to the Department of Pathology at Atal Bihari Vajpayee Government Medical College, Vidisha, from February 2023 to July 2024. Cytology slides were retrieved and reviewed by two trained cytopathologists on a single-blind basis, and two commonly used cytological grading systems, i.e., the International Academy of Cytology (IAC) Yokohama Classification and the Modified Masood Scoring Index (MMSI), were applied. Histopathology sections of available breast lesions were reviewed and correlated with cytological diagnoses.
RESULTS: Around 174 (out of a total of 535 fine needle aspirations done) cases of breast lesions were taken into account, for which cytohistopathological examinations were done. They were categorized according to the Yokohama and MMSI systems. Statistical analysis was done using histopathology as the standard.
DISCUSSION: The IAC Yokohama system demonstrated superior diagnostic accuracy, sensitivity, and clinical utility compared to the MMSI. The Yokohama system's risk of malignancy (ROM)-based, five-tiered structure provides clearer management pathways and reduced ambiguity, establishing it as the preferred universal reporting system for routine breast cytopathology.
CONCLUSION: The Yokohama system provides superior diagnostic accuracy, standardized risk stratification, and practical clinical communication compared to the MMSI. Its globally validated, ROM-based framework makes it the preferred, more reliable reporting standard.