Interobserver Agreement for the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology

Abstract

Background: A number of guidelines have been developed to improve standardization of the terminology and criteria for cytologic specimens obtained from the thyroid, pancreas, lung, and salivary glands. A major goal of these guidelines is to improve reproducibility and understanding of the reporting of diagnostic results among cytopathologists and between cytopathologists and clinicians. The International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Biopsy Cytopathology (IAC YSRB) is the most recent of these guidelines. The value of this system is, in part, dependent upon interobserver reproducibility. Design: Ninety consecutive fine-needle aspiration biopsies (FNAB) of the breast, performed over a 6-year period, were independently evaluated by 4 board-certified pathologists blinded to the original diagnoses. The 5 diagnostic categories used were those of the IAC YSRB according to published criteria for these categories. Observed agreement and chance corrected agreement (Fliess κ) were calculated. Differences in κ values were evaluated using the T statistic of Gwent. Statistical calculations were performed using STATA v16.0 (STATA Corp., College Station, TX, USA). Results: Overall agreement between observers was good. Observed unweighted agreement was 69% and weighted agreement was 91%. The majority of diagnoses were concordant (68.6%). Conclusions: Interobserver agreement of 4 cytopathologists was good using the 5 categories of the IAC YRSB (69%). Agreement was greater among pathologists with more years of experience. The IAC YSRB system appears to provide greater agreement among viewers than guidelines for cytologic specimens obtained from some other body sites (salivary gland and lung). Most discrepancies were only by a single category, with only 22/113 (19%) differing by more than one category.

The international system for serous fluid cytopathology: Interobserver agreement

“…Overall, interobserver agreement has ranged from fair to good when analyzed by calculating observed agreement, chance-corrected agreement (kappa), chance-corrected weighted agreement (weighted kappa). [8][9][10][11][12][13][14] In our study of the TIS, overall observed agreement was 68% with a chance-corrected agreement (kappa) of 51% and weighted kappa was 0.63. The chance-corrected value (kappa) and weighted kappa fall within the range of prior studies for interobserver agreement at other sites (Table 5).…”

“…However, such a distribution of cases is substantially similar to other interobserver reproducibility studies reported in the literature. [8][9][10][11][12][13][14][15] Finally, the study has only three raters for the cases. This number of cytopathologist raters is not dissimilar to other studies published in the literature.…”

Endocervical Cytology: Inter- and Intra-Observer Variability in Conventional Pap Smears

“…Very similar results ranging from only fair to moderate agreement between observers was reported for other organs, including cytological diagnoses. For example, in the fine-needle aspirations of salivary glands and breast, the overall κ-values have been reported to be 0.314 and 0.50 and the variation of values, respectively, from 0.091 to 0.539 and from 0.41 to 0.62 [27, 28].…”

Informe de la citología mamaria

“…Para complementar, el sistema internacional Yokohama también aporta algoritmos de conducta clínica para cada categoría de diagnóstico, la utilidad de las pruebas especiales como la inmunocitoquímica en bloque celular y de biología molecular en la subclasificación de la patología mamaria maligna, así como el uso de la citología en base líquida en muestras citológicas mamarias, para optimizar la evaluación multidisciplinaria de la patología mamaria y su tratamiento [2,7].…”