Cytological grading of breast carcinoma—a feasible proposition?

Abstract

Fine needle aspiration cytology (FNAC) of the breast is widely used in the diagnosis of breast carcinoma. In some centres this is sometimes the only diagnostic procedure performed prior to definitive treatment. A grading system based on cytology would be helpful in the selection of patients for appropriate therapy. The aim of this study, therefore, was to devise such a system for grading breast carcinoma based on cytological features alone. The features assessed were the degree of cell clustering, nuclear pleomorphism, nuclear diameter, the presence of multiple, easily visible nucleoli and necrosis. Cytological features were compared to the histological grade of the tumours following excision. Discriminant analysis showed that the features with the closest correlation with histological grade were nuclear diameter, nuclear pleomorphism and the presence of nucleoli. A scoring system based on these three parameters enabled the classification of tumours into high and low cytological grades which showed a close correlation with histological grade.

Robinson’s cytological grading of breast carcinoma and its correlation with Scarff Bloom Richardson’s histologic grading

“…Cellular pleomorphism is useful and it is used to assess and correlate the histological pleomorphism. 15 In our study we got 40% (n=18) cases with score 2 for cell uniformity followed by 22.2 % (n=10) cases of score 3 and 37.8 %( n=17) cases of score 1.…”

Sistemas de graduação para carcinoma de mama: estudo comparativo da concordância cito-histológica

“…Várias classificações cito-prognósticas têm sido propostas, aplicáveis para preparados citológicos e histológicos [8][9][10][11][12]18,19 . Algumas classificações baseiam-se em critérios exclusivamente nucleares, enquanto outras associam aspectos arquiteturais e nucleares.…”

“…Os sistemas que utilizam duas categorias são considerados simples e práticos, obtendo melhor reprodutibilidade intra e interobservador, além de melhor discriminação terapêutica e prognóstica 9,17 . Nesse estudo, os dois sistemas apresentaram maior concordância.…”

“…Apesar de ser método útil no diagnósti-co de carcinoma de mama, existem, ainda, poucos dados a respeito da acurácia da PAAF em estabelecer fatores prognósticos, tais como: o grau histológico e nuclear, o índice mitótico, receptores hormonais, genes de supressão tumoral/ oncogene e o conteúdo de DNA 7 . Alguns estudos têm mostrado que a graduação citológica nos esfregaços de carcinoma de mama correlaciona-se bem com a graduação histológica, sendo altamente reprodutível 7,[8][9][10][11][12][13][14][15][16] . Contudo, a graduação citológica de PAAF de mama não é rotineiramente utilizada 17 .…”

Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods

“…This is because of categorizing the breast lesions is limited to benign or malignant groups and no further cytomorphological findings are included in the cytology report to grade the breast cancers. There are several cytological grading methods like Hunt's cytological grading (HCG), Modified Black grading (MBG) and Robinson's cytological grading (RCG) to grade breast cancer [7][8][9] . Masood et al has come out with a unique method (Masood cytology index -MCI) [10] of delineating neoplastic lesions of breast into benign, borderline and malignant breast lesions on FNA smears in lieu with histopathological grading (Table 1).…”