Kusuma Kodihalli Nagaraju1, Chandana Nagendra2, Shilpa Madhav Shetty3
BACKGROUND
Breast cancer is increasing in developing countries and the management options
are wide; therefore, providing the surgeon with accurate prognostic information
on which mode of therapy will be chosen becomes important. Fine needle
aspiration cytology (FNAC) is a routinely used initial investigation of choice for
rapid diagnosis of breast cancer. Apart from diagnosis of cancer, it also has the
ability to predict the grade on smears which will add its diagnostic value without
any additional morbidity or expense for the patients. Among various cytological
grading systems, Robinson grading is most commonly used for breast carcinoma
in fine needle aspirates. The purpose of this study is to evaluate the correlation
between Robinson’s cytological grading and Bloom Richardson’s histological
grading.
METHODS
This is a 3 - year retrospective analytical study. 40 cases of infiltrating duct
carcinoma (IDC) of breast diagnosed on cytology were included in the study.
Cytological grading was done using Robinson’s grading and corresponding
histopathology slides were taken, and histological grading using Bloom
Richardson’s system was done. Finally, correlation between cytological and
histological grading was done using statistical package for social sciences (SPSS)
software.
RESULTS
Age of the patients varied between 32 and 70 yrs. Cytologically, 32.5 % cases
were grade I, 40 % were grade II and 27.5 % cases were grade III respectively.
Histologically 22.5 %, 47.5 % and 30 % cases were grade I, grade II, and grade
III, respectively. Concordance rate between grade I tumours in cytology and
histology was 53.84 %, for grade II tumours it was 75 %, and for grade III
tumours it was 63.63 %. The absolute concordance rate was 65 %.
CONCLUSIONS
Robinson’s cytological grading (RCG) of breast carcinoma correlates well with
Bloom - Richardson’s histological grading system and could be a helpful parameter
in selecting a neoadjuvant treatment for the breast cancer patients on fine needle
aspiration cytology alone.
