A review of the predictive values and malignancy risks of the YOKOHAMA system for reporting breast fine needle aspiration cytology

Abstract

Background: FNA reliably diagnoses breast lesions without surgery. Radiologists, surgeons, and oncologists can quickly communicate cytology results with a standardized care plan. The 2017 IAC conference in Yokohama established a comprehensive breast cytology system. This research examined the distribution of fine needle aspiration (FNA) cytology of breast lesions using the Yokohama 5 categories and the risk of malignancy (ROM) and predictive values of breast cytology using the International Academy of Cytology (IAC). Method: The study was conducted in the cytology laboratory of the Center of Early Detection of Breast Cancer, Oncology Teaching Hospital, Medical City Complex, Baghdad. A total of 108 consecutive patients were included in the study, and slides were collected for each patient. Results: Most patients were symptomatic and 45.9 years old. 23 (21.3%) lesions had inadequate material and were C1, whereas 14 (13%) had benign-looking epithelium and were C2. 37 (34.3%) instances exhibited mild to moderate nuclear atypia, whereas 4 (3.7%) had paucicellular smears but notable atypia and were C4. Thirty C5 lesions (27.8%) were malignant. C3 had 5.4% ROM, C4 75%, and C5 100%. Three settings determined predicted values. Group A exclusively considered C5 instances positive, with a sensitivity of 85.7%, specificity and positive predictive value (PPV) of 100%, and NPV of 77.3%. Group B regarded C4 and C5 instances as positive, with sensitivity of 94.3%, specificity of 94.1%, NPV of 88.9%, and PPV of 97.1%. With 100% sensitivity and 67.3% PPV, Group C deemed C3, C4, and C5 cases positive. Conclusion: The FNA had the greatest specificity (100%), sensitivity (100%), and accuracy (94.2%) when C4 and C5 were positive. The research emphasizes the need for a standardized breast cytology system to facilitate communication between radiologists, surgeons, and oncologists.