Milan Scoring System in the Diagnosis of Salivary Gland Lesions for Assessment of Risk of Malignancy: A Retrospective Study

Abstract

Background: Fine-needle aspiration cytology (FNAC) plays a pivotal role in the evaluation of salivary gland lesions. The Milan System for Reporting Salivary Gland Cytopathology standardizes reporting and stratifies the risk of malignancy (ROM).
Objective: To evaluate the diagnostic utility of the Milan scoring system in salivary gland lesions and assess the associated risk of malignancy.
Methods: A retrospective study was conducted on 200 cases at the Department of Pathology, M.K.C.G Medical College and Hospital, Berhampur, Odisha, from August 2023 to July 2025. FNAC cases were categorized according to the Milan system and correlated with histopathology wherever available. Statistical analysis included sensitivity, specificity, and Chi-square test.
Results: Out of 200 cases, the highest frequency was observed in Category IV (neoplasm benign). The overall risk of malignancy increased progressively across categories, with significant association (χ² = 28.6, p < 0.001). Sensitivity, specificity, and diagnostic accuracy were 85.2%, 92.4%, and 89.5%, respectively.
Conclusion: The Milan system is a reliable and standardized tool for risk stratification of salivary gland lesions and aids in clinical decision-making.