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Diagnostic Category 4

Hmm...I've been looking on the internet and I found this:

ABSTRACT
Introduction: This study aims to correlate fineneedle
aspiration specimens diagnosed as C3
(atypical, probably benign) and C4 (suspicious,
probably malignant) with histology and
mammography, and to evaluate these two
cytology categories in terms of diagnostic
usefulness and patient management.
Methods: All fine-needle aspiration (FNA)
specimens in categories C3 or C4 at the Maharaj
Nakorn Chiang Mai Hospital, Thailand between
2000-2004 were reviewed. Results were correlated
with available histological and mammographical
studies.
Results: 148 FNA specimens were identified,
comprising 43 category C3 and 105 category C4.
Histology was available in 90 cases. 14 (64 percent)
C3 cases showed benign histology on biopsy and
eight (36 percent) were malignant. 13 (19 percent)
C4 cases were benign on biopsy, whereas 55
(81 percent) were malignant. Mammographical
studies were available in 56 of the histologicallyproven
cases. All seven cases with benign
mammograms had benign histology, and all 26
cases called “highly suggestive of malignancy”
were malignant on histology (five C3 and 21 C4).
Of the 23 cases called “suspicious abnormality”
on mammography, 14 turned out to be malignant
on biopsy (one C3 and 13 C4).
Conclusion: Our study supports maintaining
cytology categories C3 and C4. About two-thirds
of C3 cases were benign on biopsy whereas
81 percent of C4 cases were malignant (p-value is
less than 0.001). There was complete correlation
between histological and mammographical
studies except those with equivocal mammograms.
Our study supports the combined use of clinical,
mammographical and cytological findings for
optimal patient management. This is especially
important for patients with C3 aspiration
results, in order to avoid unnecessary surgery for
benign lesions.

Yikes...so according to this 81 percent of C4 cases were malignant! That's a high percentage. :(
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