OBJECTIVE We aimed to assess the risk of malignancy (ROM) and predictive values in prior breast cytology studies as a basis for the new International Academy of Cytology (IAC) Yokohama system for reporting breast fine-needle aspiration biopsy (FNAB) cytology, which classifies cytologic diagnoses into 5 categories: (1) insufficient material, (2) benign, (3) atypical, (4) suspicious of malignancy, and (5) malignant. STUDY DESIGN Publications between January 1, 1997, and December 31, 2017, that studied the performance characteristics of FNAB from palpable and nonpalpable breast masses were identified through the PubMed database. Data for number of total cases and cases within each diagnostic category, if available, were collected. Performance characteristics, including absolute sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and ROM for each category were recorded or, when possible, calculated. RESULTS The literature review resulted in a case cohort of 33,341 breast FNABs, drawn from 27 studies. Pooling these cases together, the ROM for insufficient material, benign, atypical, suspicious, and malignant were 30.3, 4.7, 51.5, 85.4, and 98.7%, respectively. The complete sensitivity and specificity were 96.3 and 98.8%, correspondingly. The PPV and NPV were 98.7 and 95.3%, correspondingly. The false-negative and false-positive rates were 3.7 and 1.0%, respectively. CONCLUSIONS This meta-analysis demonstrates that the diagnostic categories of the new IAC Yokohama System each carry an implied ROM, which increases from the benign to malignant categories. This study also shows the high sensitivity and specificity of FNAB for breast lesions.

中文翻译：

---

国际细胞学学会横滨系统报告乳腺癌细针穿刺活检细胞病理学：预测价值和恶性肿瘤风险的回顾。

目的我们旨在评估先前的乳房细胞学研究中的恶性肿瘤（ROM）风险和预测值，以此作为新的国际细胞学学会（IAC）横滨系统报告乳房细针穿刺活检（FNAB）细胞学的基础细胞学诊断分为5类：（1）材料不足，（2）良性，（3）非典型，（4）可疑恶性和（5）恶性。研究设计通过PubMed数据库确定了1997年1月1日至2017年12月31日之间从可触及不触及乳腺肿块研究FNAB性能特征的出版物。收集了总病例数和每个诊断类别中的病例（如果有）的数据。性能特征，包括绝对敏感性，特异性，阳性预测值（PPV），记录或尽可能计算出每个类别的阴性预测值（NPV）和ROM。结果文献综述得出了来自27项研究的33341例乳腺FNAB病例队列。综合考虑这些病例，ROM的材料不足，良性，非典型，可疑和恶性的比率分别为30.3、4.7、51.5、85.4和98.7％。完全敏感性和特异性分别为96.3和98.8％。PPV和NPV分别为98.7％和95.3％。假阴性和假阳性率分别为3.7％和1.0％。结论这项荟萃分析表明，新的IAC横滨系统的诊断类别每个都包含一个隐含的ROM，从良性到恶性增加。这项研究还显示了FNAB对乳腺病变的高度敏感性和特异性。