Swayam Prava Pradhan 1 , Anusuya Dash 2 , Sulata Choudhury 3 , Debi Prasad Mishra
BACKGROUND Breast carcinoma is one of the most common cancer of women. Fine-Needle Aspiration Cytology (FNAC) is widely used, most convenient, quick and common preoperative diagnostic modality in breast lesions. Cytological grading on aspirates of breast carcinoma is a very useful tool for surgical manoeuvre and prognosis. The aim of the study is to study the correlation of cytomorphological Robinson’s grading with modified Bloom-Richardson’s histopathological grading of breast carcinoma. MATERIALS AND METHODS In the present study, 140 cytologically malignant breast tumour cases were included in the study and out of which, 90 cases correlated with histology after mastectomy. FNA was performed with 22-24 gauze needle and smears were stained with Haematoxylin and Eosin, Papanicolaou and May-Grunwald-Giemsa and evaluated for cytological grading according to Robinson’s grading system. H and E stained histosections were graded according to Bloom-Richardson’s grading system and comparison were done between the two. RESULTS Robinson’s cytological grading correlated well with Bloom-Richardson’s histopathological grading. The concordance rate between cytology and histology of Grade I, Grade II and Grade III tumours were 84.61%, 79.16% and 87.5%, respectively. Overall, concordance was found to be 83.6%. The Kappa value showed 95% confidence level. Thus, the strength of agreement between two grading systems considered to be fair. The P value on chi-square analysis showed <0.0001, which was considered statistically significant. Hence, the cytological grading is comparable with histological grading. CONCLUSION Robinson’s cytological grading of breast carcinoma correlates well with Bloom-Richardson’s histomorphological grading system. Hence, cytological grading in FNAC smears can be used as a prognostic factor for choosing the newer treatment modalities.
