The International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology

1. Front Matter

   Pages i-xii

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2. The International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology: Introduction and Overview

   • Andrew S. Field, Wendy A. Raymond, Mary T. Rickard, Lauren Arnold, Elena F. Brachtel, Benjaporn Chaiwun et al.

   Pages 1-9

3. Insufficient/Inadequate

   • Wendy A. Raymond, Andrew S. Field, Andrew H. S. Lee, Fernando Schmitt

   Pages 11-17

4. Benign

   • Andrew S. Field, Luigi Di Bonito, Maurizio Pinamonti, Pamela Michelow, Wendy A. Raymond, Torill Sauer et al.

   Pages 19-49

5. Atypical

   • Andrew S. Field, Britt-Marie Ljung, Mary T. Rickard, Gary M. Tse, Torill Sauer, Andrew H. S. Lee et al.

   Pages 51-66

6. Suspicious of Malignancy

   • Andrew S. Field, Torill Sauer, Britt-Marie Ljung, Andrew H. S. Lee, Wendy A. Raymond, William R. Geddie et al.

   Pages 67-82

7. Malignant

   • Elena F. Brachtel, Andrew S. Field, Mary T. Rickard, Wendy A. Raymond, Andrew H. S. Lee, P. Y. Chong et al.

   Pages 83-118

8. An Approach to the Interpretation of Breast Fine Needle Aspiration Biopsy Cytopathology Direct Smears

   • Andrew S. Field, Wendy A. Raymond, Fernando Schmitt

   Pages 119-129

9. Nipple Cytopathology

   • Andrew H. S. Lee, Andrew S. Field

   Pages 131-135

10. Role of Ancillary Tests in Breast Fine Needle Aspiration Biopsy Cytopathology

    • Francisco Beca, Fernando Schmitt

    Pages 137-157

11. Fine Needle Aspiration Biopsy Cytopathology of the Breast Utilizing Liquid-Based Preparations

    • Fernando Schmitt, Rana S. Hoda

    Pages 159-174

12. Clinical Management

    • Ruben Cohen-Hallaleh, Mary T. Rickard, Elgene Lim, Wendy A. Raymond, Davendra Segara, Lauren Arnold et al.

    Pages 175-180

13. Back Matter

    Pages 181-185

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This text describes a system of reporting breast fine needle aspiration biopsy that uses five clearly defined categories, each described by a specific term and each with a specific risk of malignancy. The five categories are insufficient/inadequate, benign, atypical, suspicious of malignancy and malignant. Each category has a risk of malignancy and is linked to management recommendations, which include several options because it is recognized that diagnostic infrastructure, such as the availability of core needle biopsy and ultrasound guidance, vary between developed and low and middle income countries. This text includes key diagnostic cytological criteria for each of the many lesions and tumors found in the breast. The cytopathology of specific lesions is illustrated with high quality photomicrographs with clear figure descriptions. Chapters also discuss current and potential future ancillary tests, liquid based cytology, nipple cytology and management. An additional chapter provides an overview of an approach to the diagnosis of direct smears of breast fine needle aspiration biopsies.


The International Academy of Cytology Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology provides a clear logical approach to the diagnosis and categorization of breast lesions by FNAB cytology, and aims to facilitate communication with breast clinicians, further research into breast cytopathology and related molecular pathology, and improve patient care.    

• Ancillary immunohistochemistry
• molecular testing
• breast lesions
• Nipple discharge cytology
• Liquid Based Cytology

• University of NSW and University of Notre Dame Medical Schools, St Vincent’s Hospital, Sydney, Australia

  Andrew S. Field

• Flinders Medical Centre, Flinders University of South Australia and Clinpath Laboratories, Adelaide, Australia

  Wendy A. Raymond

• Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP), Medical Faculty of Porto University, Porto, Portugal

  Fernando Schmitt

Andrew S. Field
University of NSW and University of Notre Dame Medical Schools
St Vincent’s Hospital
Sydney, Australia



Wendy A. Raymond
Flinders Medical Centre, Flinders University of South Australia and Clinpath Laboratories
Adelaide, Australia






Fernando Schmitt
Institute of Molecular Pathology and Immunology of Porto University (IPATIMUP)
Medical Faculty of Porto University
Porto, Portugal

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