The Bethesda System's Role in Enhancing Thyroid Cancer Diagnosis: A Cytohistological Analysis

Introduction Thyroid diseases are prevalent worldwide and accounts for approximately 42 million cases in India. Palpable thyroid nodules are about 4-7% in the middle-aged population and increase with age. FNAC is the first-line of investigation for evaluating the thyroid nodules. It is a quick, easy and cost effective test to differentiate benign from malignant thyroid lesions. Thyroid fine-needle aspiration cytology (FNAC) is essential for the initial evaluation and clinical management of thyroid nodules. At present, most thyroid FNAC specimens are classified with The Bethesda System for Reporting Thyroid Cytopathology. This scheme consists of 6 major diagnostic categories, each of which is associated with an implied risk of malignancy (ROM). The ROM represents a fundamental component of TBSRTC that influences subsequent clinical management decisions. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was introduced at the National Cancer Institute, (NCI) Bethesda, Maryland in 2007. This system categorized the FNAC of thyroid into six diagnostic groups with well-defined cancer risks and clear indications for further clinical management. Bethesda system was introduced to overcome the ambiguity by introducing six categories to standardise the reporting and ensure uniformity of interpretation. The study aimed to evaluate the diagnostic utility and reproducibility of “The Bethesda System for Reporting Thyroid Cytopathology”.