Role of Cytological Grading in Prognostication of Breast Carcinoma

  • Smita Surendra Masamatti Assosciate professor, Department of pathology, Sapthagiri institute of medical sciences and research centre, Bangalore 560090
  • Vijaya C Professor and HOD,Department of pathology, Sapthagiri institute of medical sciences and research centre, Bangalore 560090
  • Narayana Swamy DM Assistant professor and statistician, Department of community medicine, BGS Global institute of medical sciences, Bangalore
DOI: https://doi.org/10.21276/apalm.1997
Keywords: Elston and Ellis’s Nottingham modification of Bloom Richardson’s method, FNAC, Histological grading, Robinson’s cytological grading

Abstract

Background: Breast carcinoma is now one of the most common cause of death in females worldwide, hence should be early diagnosis and treatment is necessary. This study aims at establishing Fine needle aspiration cytology (FNAC) as an individual parameter in diagnosing and grading breast carcinoma followed by correlation with histological grading.   Methods: Cytological smears of 51 cases of breast carcinomas were graded by using Robinson’s method and corresponding histology sections were graded according to Elston and Ellis Nottingham modification of Bloom Richardson’s method and correlation was done.   Result: On cytology, there were 10,26 and 15 cases of grade I, grade II and grade III tumours respectively while on histology there were 12, 31 and 8 cases of grade I, grade II and grade III tumours. The concordance rates between cytology and histology grades were 90%, 76.92% and 26.67% respectively with an absolute concordance rate of 64.71%.   Conclusion: FNAC is simple, non invasive and a very good tool which provides information about the aggressiveness of the tumour and helps to select appropriate treatment.

References

1) Wani FA, Bhardwaj S, Kumar D, Katoch P. Cytological grading of breast cancers and comparative evaluation of two grading systems. J Cytol 2010; 27(2): 55–58.
2) Pandya AN, Shah NP. Comparative Evaluation of Robinson’s Cytological Grading with Elston and Ellis’ Nottingham Modification of Bloom Richardson Histopathology Grading for Breast Carcinoma. Natl J Community Med 2012; 3(3):491-5.
3) Bansal C, Pujani M, Sharma KL, Srivastava AN, Singh US. Grading systems in the cytological diagnosis of breast cancer: A review. J Can Res Ther 2014; 10:839-45.
4) Das AK, Kapila K, Dinda AK, Verma K. Comparative evaluation of grading of breast carcinomas in fine needle aspirates by two methods. Indian J Med Res 2003; 247-250.
5) Chhabra S, Singh PK, Agarwal A, Bhagoliwal A, Singh SN. Cytological grading of breast carcinoma: A multivariate regression analysis. J Cytol 2005; 22:62–5.
6) Sultana T, Rahman AJ. Cytological grading of duct cell carcinoma, NOS of breast and its correlation with histological grading. Bangladesh Med Res Counc Bull.2006; 32(2):49-54.
7) Khan MZ, Haleem A, AI Hassani H, Kfoury H. Cytopathological grading, as a predictor of histopathological grade, in ductal carcinoma (NOS) of breast, on air-dried Diff-Quik smears. Dign Cytopathol 2003; 29:185–93.
8) Sinha SK, Sinha N, Bandyopadhyay R, Mondal SK. Robinson's cytological grading on aspirates of breast carcinoma: Correlation with Bloom Richardson's histological grading. J Cytol 2009; 26:140–3.
9) Lingegowda JB, MuddeGowda PH, Ramakantha CK, Chandrasekar HR. Cytohistological correlation of grading in breast carcinoma. Diagn Cytopathol 2011; 39:251–7.
10) Arul P, Masilamani S. Comparative evaluation of various cytomorphological grading systems in breast carcinoma. Indian J Med Paediatr Oncol 2016; 37:79-84.
11) Robinson IA, McKee G, Kissin MW. Typing and grading of breast carcinoma on fine-needle aspiration: is this clinically useful information? Diagn Cytopathol 1995; 13: 260-5.
12) Zoppi JA, Pellicer EM, Sundblad AS. Cytohistologic correlation of nuclear grade in breast carcinoma. Acta Cytol 1997; 41:701–4.
13) Cajulis RS, Hessel RG, Hwang S, Haines K, Frias-Hidvegi D, O’Gorman M. Simplified nuclear grading of fine-needle aspirates of breast carcinoma: concordance with corresponding histologic nuclear grading and flow cytometric data. Diagn Cytopathol 1994; 11:124–30.
14) Mustaphi RM, Chowdhury S, Mondal S, Bhattacharya SK, Sarkar S, Saha Tk. Role of cytological grading in breast cancer prognosis and its histopathological correlation.Journal of dental and medical sciences 2014;13(10):106-109.
15) Gupta N, Mangal K. Mehra M. “Diagnostic accuracy of Robinson's cytological grading assuming modified Scarff bloom Richardson's histological grading as a gold standard in malignant Neoplasms of breast. International journal of Current Research 2016; 8 (01):25429-25435.
16) Meena SP, Hemrajani DK, Joshi N. A comparativeand evaluative study of Cytological and Histological grading system profile in malignant neoplasm of breast-an important prognostic factor. Indian J Pathol Microbiol 2006; 49(2):199-202.

17) Chandanwale SS, Mishra N, Kaur S, Paranjape S, Pandey A, Jha M. Comparative analysis of six cytological grading systems in breast carcinoma. Clin Cancer Investig J 2016; 5:409-15.
18) Taniguchi E, Yang Q, Tang W, Nakamura Y, Shan L, Nakamura M, et al. Cytological grading of invasive breast carcinoma. Correlation with clinicopathologic variables and predictive value of nodal metastasis. Acta Cytol 2000;44:587-91.
19) Vasudev, Vidya, Rangaswamy R., Geethamani V. “The Cytological Grading of Malignant Neoplasms of the Breast and Its Correlation with The Histological Grading.” Journal of Clinical and Diagnostic Research 2013; 7(6): 1035–1039.
20) Sood N, Nigam JS, Yadav P et al. Comparative study of cytomorphological Robinson's grading of breast carcinoma with Modiied Bloom-Richardson histopathological grading. Pathology research international 2013; 146542:1-5.
21) Einstien D, Omprakash BO, Ganapathy H, Rahman S. Comparison of 3-tier cytological grading systems for breast carcinoma. ISRN Oncol 2014; 2014:252103.
22) Howell LP, Gandour-Edwards R, O'Sullivan D. Application of the Scarff-Bloom-Richardson tumor grading system to fine-needle aspirates of the breast. Am J Clin Pathol 1994;101:262-5.
Published
2018-05-22
Issue
Vol 5 No 5 (2018)
Section
Original Article

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