Fine-needle aspiration cytology of breast lesions using the NCI c1–c5 reporting system: A one-year retrospective observational study in a tertiary care hospital.
DOI:
https://doi.org/10.51168/sjhrafrica.v7i3.2491Cuvinte cheie:
Breast lump, fine-needle aspiration cytology, National Cancer Institute, Breast Imaging Reporting and Data System, fibroadenoma, ductal carcinoma, BI-RADSRezumat
Background:
Fine-needle aspiration cytology (FNAC) is widely used for rapid triage of breast lumps, particularly where access to immediate core biopsy is constrained. Standardized category-based reporting improves clarity and supports consistent clinical decision-making.
Objectives:
To describe the spectrum of breast lesions evaluated by FNAC over one year using the National Cancer Institute (NCI) C1–C5 reporting system and to summarize the completeness of basic radiology documentation.
Methods:
A retrospective observational audit was performed over one year in a tertiary care pathology service. Consecutive breast FNAC cases were extracted from routine registers. Age, recorded laterality, and BI-RADS category, NCI category assignment, repeat aspiration events, and final cytological diagnosis were compiled and summarized using descriptive statistics.
Results:
A total of 59 breast FNAC cases were included. The age ranged from 12–70 years (mean 39.44 ± 14.07). Benign category C2 predominated (41 cases), followed by malignant category C5 (15 cases). Atypical category C3 constituted 2 cases, and inadequate smears (C1) constituted 1 case. Fibroadenoma/fibroadenosis spectrum formed the largest diagnostic group (29 cases), while ductal carcinoma spectrum accounted for 15 cases. Repeat aspiration was performed in two cases, yielding a final benign diagnosis in one and a malignant diagnosis in one.
Conclusion:
Over the one-year audit period, breast FNAC was predominantly reported as benign, with fibroadenoma/fibroadenosis constituting the largest diagnostic group. BI-RADS information was incompletely recorded, highlighting the need for standardized requisition proformas and tighter clinicoradiological linkage to reinforce triple assessment, streamline triage, and improve continuity of care.
Recommendations:
Routine capture of laterality and BI-RADS category, preferential use of ultrasound guidance for challenging lesions, and rapid on-site adequacy checks, where feasible, can improve report quality and reduce repeat procedures.
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