Objective: This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. Study Design: Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. Results: The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. Conclusion: This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.
Acta Cytologica

中文翻译：

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根据IAC横滨报告乳腺细胞病理学的男性乳腺病变的分类

目的：本研究旨在确定国际细胞学学会（IAC）横滨系统在男性乳房病变中报告乳房细胞病理学的诊断实用性。研究设计：根据5层IAC横滨报告系统对2015年至2019年的细针穿刺活检（FNAB）报告进行了回顾性重新分类。我们的数据库从1,350名男性患者中获得了总计1,532个FNAB报告，来自乳腺病变。对于每个类别，使用随访组织病理学诊断和/或临床随访（如果可用）确定恶性肿瘤（ROM）的风险和FNAB的诊断性能。结果：类别分布如下：不足，40％；良性57％；非典型，0.6％；可疑恶性肿瘤，占0.7％；和恶性的1.6％。每种类别的ROM均无法诊断，占11％；良性，3％；非典型的，占28％；可疑恶性肿瘤占56％；和恶性的100％。当仅将恶性病例视为阳性测试时，敏感性，特异性，阳性预测值和阴性预测值分别记录为63、100、100和84.6％。结论：这项研究验证了IAC横滨系统用于报告男性乳房细胞病理学的有效性。根据横滨系统建立报告乳腺细胞病理学最佳实践指南的目的，该综合方案促进了本地和国际机构之间的比较。ROM充当内部实验室对质量保证的内部审核，并为临床管理提供指导。它突出了低效率，如高不足率1类，还设有令人印象深刻的特异性优势的类别4和5
ACTA Cytologica