Applicability of Cytological Grading of Carcinoma Breast

  • Saroj Pachori Department of Pathology, Sawai Man Singh Medical College, Jaipur (Rajasthan)
  • Kriti Chaturvedi Department of Pathology, Jawahar Lal Nehru Medical College, Ajmer (Rajasthan)
  • Geeta Pachori Department of Pathology, Jawahar Lal Nehru Medical College, Ajmer (Rajasthan)
  • Tarun tiwari Department of Respiratory Medicine and TB, Jawahar Lal Nehru Medical College, Ajmer (Rajasthan)
  • Disha jain Department of Pathology, Jawahar Lal Nehru Medical College, Ajmer (Rajasthan)
Keywords: FNAC, H&E, MBR


Background: In India breast cancer incidence is on rise and large number of cases occur before 50 years of age. Early diagnosis and proper treatment are known to increase the survival of the patients. As fine needle aspiration cytology is widely used as a preliminary mode for the diagnosis of breast malignancies, adding a reliable grading system in reporting shall aid in planning the management options. Methods: It’s a prospective study done on 100 cases of breast malignancies from June 2018 to May 2020 in department of Pathology JLNMC, Ajmer. Cytology smears were stained with H&E and Geimsa and graded according to Robinson’s cytological grading system while their corresponding histopathological sections were stained with H&E and graded as per Elston and Ellis modification of Scarff Bloom & Richardson grading system and the results were compared. Result: Out of 100 cases of breast cancer evaluated in cytology 29% were grade I, 56% were grade II and 15% were grade III. On histopathological evaluation 25% were grade I, 54% were grade II while 21% were grade III. A highly significant association between the two grading systems was observed with coefficient of correlation 0.831, p value of <0.001 and concordance rate 80%. Conclusion: There is high degree of concordance between the Robinson’s and Elston and Ellis modification of Scarff Bloom & Richardson grading system. Robinson’s method is an easy and quick and reliable method to grade carcinomas of breast, hence it should be included in cytology reporting of breast carcinomas.


GLOBOCAN 2008 FACT SHEET 2010, Breast cancer incidence and mortality worldwide 2008 summary.

GLOBOCAN 2008, World fact sheet, 2012, 2010, section of cancer information, international agency for research on cancer, Lyon, France.

Sinha A, Gill SS. Correlative study of cytological features in grading of invasive breast carcinoma. J Cytol 2018;35:149-52.

Srivastava P, Kumar B, Joshi U, Bano M. To evaluate the applicability of parameters of cytological grading systems on aspirates of breast carcinoma. J Cytol 2018;35:15-21.

1. Breast Cancer Grades | Grading Breast Cancer [Internet]. 2021 [cited 23 July 2021]. Available from:

Jyothi B. Lingegowda et al. Cytohistological Correlation of Grading in Breast Carcinoma. Diagnostic Cytopathology, Vol 39, No 4.

Kocjan, Gabrijela., Gray, Winifred. Diagnostic Cytopathology E-Book: Expert Consult: Online and Print. United Kingdom: Elsevier Health Sciences, 2010.

Robles‑Frias A, Gonzalez‑Campora R, Martinez‑Parra D, Robles‑Frias M, Vazquez‑Cerezuda T, Otal‑Salaverri C, et al. Robinson cytologic grading of invasive ductal breast carcinoma. Correlation with histologic grading and regional lymph node metastasis. Acta Cytol 2005;49:149‑53.

Robinson IA, McKee G, Nicholson A, D’Arey J, Jackson PA, Cook MG, et al. Prognostic value of cytological grading of fine‑needle aspirates from breast carcinomas. Lancet 1994;343:947‑49.

Chhabra S, Singh PK, Agarwal A, Bhagolival A, Singh SN. Cytological grading of breast carcinoma‑A multivariate regression analysis. J Cytol 2005;22:62‑5.

Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. The value of histological grade in breast cancer:experience from a large study with long-term follow up. Histopathology 1990;19:403-10

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;101:262–265.

Pandya A et al. Comparative evaluation of robinson’s cytological grading with elston and ellis’ nottingham modification of bloom richardson histopathology grading for breast carcinoma. National Journal of Community Medicine

Chalsie S. et al, Correlation between Robinson’s cytological grading with Modiied Bloom-Richardson histopathological grading for Breast carcinoma. Journal of Pathology of Nepal (2015) Vol. 5, 791 -797

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;118:247–50.

Rekha TS, Nandini NM, Dhar M. Validity of different cytological grading systems of breast carcinoma – a hospital-based study in South India. Asian Pac J Cancer Prev. 2011;12:3013–6.

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;3:491–5. systems in breast carcinoma. J Cytol. 2013;30:87–93.

Teronpi Jasmine, Reena Kouli. Comparative study of fine needle aspiration cytology and histopathology in grading breast carcinoma. International Journal of Contemporary Medical Research 2019;6(7):G21-G25.

Pal S, Gupta ML. Correlation between cytological and histological grading of breast cancer and its role inprognosis. J Cytol 2016;33:182-6.

Sood N et al. Comparative Study of Cytomorphological Robinson’s Grading for Breast Carcinoma with Modified Bloom-Richardson Histopathological Grading. Hindawi Publishing Corporation Pathology Research International Volume 2013

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