Diagnostic cytopathology · 2026
The Yokohama System for Breast Cytology in Japan: A Multicenter Comparison of the International Academy of Cytology Yokohama System and the Conventional Japanese System for Reporting Breast Fine-Needle Aspiration Biopsy.
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Hoshino Akiyoshi, Maeda Ichiro, Nishimura Rieko, Abe Eiji, Kozuka Yuji, Masuda Shinobu, Ohi Yasuyo, Sakatani Takashi, Tsuda Hitoshi, Ito Hitoshi, Tsuchiya Shin-Ichi, Osamura Robert, Moriya Takuya, Working group on the accuracy of breast fine needle aspiration cytology of the Japanese Society of Clinical Cytology
Аннотация
BACKGROUND: The International Academy of Cytology (IAC) recently introduced the Yokohama System (IAC-YS) for reporting breast fine-needle aspiration biopsy (FNAB) cytology. The Working Group on the Accuracy of Breast Fine-Needle Aspiration Cytology of the Japanese Society of Clinical Cytology aimed to categorize breast FNAB specimens according to the IAC-YS, assess the risk of malignancy (ROM) for each category, and evaluate the diagnostic yield of breast FNAB in Japan.
METHODS: Breast FNAB specimens obtained between January 2010 and December 2019 from nine cooperating facilities were retrospectively reclassified following the IAC-YS. The ROM for each category was calculated and compared with that using the conventional Japanese diagnostic system (CJS). Diagnostic yield was evaluated using a five-category approach to distinguish benign from malignant samples.
RESULTS: In total, 1727 samples from 1722 patients were distributed as follows: Category 1 (insufficient material), 21.3%; Category 2 (benign), 38.9%; Category 3 (atypical), 6.9%; Category 4 (suspicious for malignancy), 10.0%; and Category 5 (malignant), 23.0%. Histological follow-up was available for 856 cases (49.5%). The ROM was 13.1%, 4.8%, 26.9%, 84.3%, and 94.5% for Categories 1-5, respectively.
CONCLUSIONS: IAC-YS showed a higher proportion of cases of Category 1 and a lower proportion of cases of Category 3 than the CJS. Despite these differences, both systems were equivalent in their impact on daily medical care, although ROM differed for the content of Categories 1 and 3. Quality assurance parameters for our data based on IAC-YS are comparable to those of CJS.
METHODS: Breast FNAB specimens obtained between January 2010 and December 2019 from nine cooperating facilities were retrospectively reclassified following the IAC-YS. The ROM for each category was calculated and compared with that using the conventional Japanese diagnostic system (CJS). Diagnostic yield was evaluated using a five-category approach to distinguish benign from malignant samples.
RESULTS: In total, 1727 samples from 1722 patients were distributed as follows: Category 1 (insufficient material), 21.3%; Category 2 (benign), 38.9%; Category 3 (atypical), 6.9%; Category 4 (suspicious for malignancy), 10.0%; and Category 5 (malignant), 23.0%. Histological follow-up was available for 856 cases (49.5%). The ROM was 13.1%, 4.8%, 26.9%, 84.3%, and 94.5% for Categories 1-5, respectively.
CONCLUSIONS: IAC-YS showed a higher proportion of cases of Category 1 and a lower proportion of cases of Category 3 than the CJS. Despite these differences, both systems were equivalent in their impact on daily medical care, although ROM differed for the content of Categories 1 and 3. Quality assurance parameters for our data based on IAC-YS are comparable to those of CJS.