Diagnostic Accuracy of Modified Masood’s Scoring Index for Reporting Breast Cytopathology

Background and Aims: The Modified Masood’s Scoring Index (MMSI) categorizes breast fine-needle aspirates into four categories nonproliferative breast diseases (PBDs), PBD without atypia, PBD with atypia and carcinoma in situ or carcinoma. Very few studies have been conducted so far to assess the diagnostic accuracy of this system. The objectives of the present study were to classify breast fine-needle aspirates according to the MMSI and assess their risk of malignancy (ROM) and performance parameters. Materials and Methods: All breast FNAs received from January 2022 to July 2023 were classified into four categories according to the MMSI. Using histopathological diagnosis as the gold standard, ROM and performance parameters were calculated. Results: Out of the 387 breast fine-needle aspirates, histopathological correlation was available for 253 cases. The ROM for non-PBD, PBD without atypia, PBD with atypia, and carcinoma in situ or carcinoma categories were 0%, 1.5%, 7.7%, and 98.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 96.59%, 99.39%, 98.84%, 98.20%, and 98.42%, respectively. Conclusion: The MMSI demonstrates high diagnostic accuracy, sensitivity, and specificity for breast fine-needle aspirates, effectively categorizing lesions and aiding in clinical decision-making. Our study confirms the utility of MMSI in distinguishing between benign and malignant breast lesions, particularly in cases with mild atypia. The parameters used in MMSI enhance the reliability of fine-needle aspiration cytology reports, thereby supporting surgeons in determining appropriate treatment strategies.