Robinson Cytologic Grading of Invasive Ductal Breast Carcinoma

Background:Evaluation of cytologic features is indispensable in the preoperative diagnosis and grading of infiltrating ductal breast carcinoma (CA) in fine-needle aspiration cytology (FNAC) material and this method can also provide additional information regarding intrinsic features of the tumor as well as its prognosis.Aim:This study has been done to evaluate comparatively the cytologic and histomorphologic grading of infiltrating ductal carcinoma of breast with specific reference to lymph node metastasis and its role in prognostication.Materials and Methods:Forty three patients who underwent FNAC and mastectomy for infiltrating ductal carcinoma were cytologically and histologically graded (employing Robinson's cytologic grading system and Elston's modification of Bloom-Richardson system, respectively). Statistical analysis was done employing ‘z’ test and χ2 test to compare the two grading system and to examine the degree of correlation between the cytologic and histologic grades. Multiple regression analysis was done to assess the significance of every cytologic and histologic parameter. All 43 cases, graded cyto-histologically were also evaluated for presence or absence of metastasis to the regional lymph nodes employing χ2 test.Results:With histologic grade taken as the standard, cytology was found to be fairly comparable, for grading breast carcinoma (overall sensitivity 89.1%, specificity 100%). Further comparison of the two grading systems by Z-test showed that difference between the cytologic and histologic grading was insignificant in all the three grade (P > 0.05). Of the six parameters studied, cell dissociation, nucleoli and chromatin pattern were the most influential features (P < 0.001). The statistically significant difference (p < 0.001) was found in incidences of axillary lymph node metastatic rate in three cytologic grades (15.4% in grade I vs. 83.3% in grade III) as well.Conclusions:Apart from being simple and noninvasive, cytologic grading is comparable to histologic grading and might provide relevant information on the aggressiveness of invasive ductal carcinoma of breast and could be a useful parameter to take into consideration when selecting mode of therapy and to predict tumor behavior.

Section: Discussionmentioning

confidence: 92%

Role of cytologic grading in prognostication of invasive breast carcinoma

Khan

Afroz

Rana

et al. 2009

“…Frias et al . [15] and Khan et al . [1] also reported an increased rate of axillary lymph node metastasis with increasing cytological grade.…”

Section: Discussionmentioning

confidence: 99%

Correlation between cytological and histological grading of breast cancer and its role in prognosis

Pal

Gupta

2016

Context:Assigning grade to breast cancer on FNAC provides prognostic information and guides optimal therapy.Aims:The present study was undertaken to grade breast carcinoma on cytology by Robinson's grading system and correlate it with Elstons modified Bloom Richardson histological grading system.Settings and Design:It is a prospective study done on fifty cases of breast cancer reported on cytology.Materials and Methods:Fifty patients who underwent FNAC and mastectomy for breast carcinoma were cytologically and histologically graded. Correlation between cytological and histological grading system was determined. Sensitivity and specificity of Robinson's cytological grading system was calculated in each grade. All cases evaluated for presence of metastasis to axillary lymph nodes.Statistical Analysis Used:Correlation between cytological and histological grading was established using the non parametric Spearmanâ€™ s correlation coefficient.Results:Concordance rate between cytological and histological grade was 78%. The coefficient of correlation between cytological grade and histological grade was 0.804 and P value was <0.001 which indicated a strong correlation and significant association between the cytological and histological grade. Sensitivity was maximum in cytological grade I tumors (100%) and least in cytological grade III tumors (45.45%). Specificity was maximum in cytological grade III tumors (94.87%) and least in cytological grade II tumors (72.72%). The incidence of axillary lymph node metastasis was maximum in cytological grade III tumors and grade I tumors.Conclusions:Cytological grade strongly predicts histological grade and is useful in selecting neoadjuvant chemotherapy.

“…[21] evaluated cytological grade by using the Robinson's method and the histological grade by using the Elston modification of the Bloom–Richardson method on 100 patients of IDC, NOS. A statistically significant association was observed between cytological and histological grades ( P < 0.0005).…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of six cytological grading systems in breast carcinoma

Kaushik

Raychaudhuri

Chattopadhyay

et al. 2013

Background:Cytological grading is a useful tool for selection of therapy and prognosis in breast carcinoma. Despite having many cytological grading systems, there is still no agreement among pathologists to accept one of them as a gold standard.Aim:This study was undertaken to evaluate six such three-tier cytological grading systems to determine which system corresponds best to histological grading done by Nottingham modification of Scarff Bloom Richardson (SBR)'s method.Materials and Methods:In a double-blind study, preoperative cytological grades obtained by six systems on fine-needle aspiration cytology (FNAC) smears were compared by testing concordance, association and correlation with histological grade derived postoperatively by the SBR's method in 57 patients of breast carcinoma. Bivariate correlation studies and multiple linear regressions were done to assess the significance of the different cytological parameters to predict final cytological grades.Results:Robinson's system demonstrated the best correlation (ρ = 0.799; P = 0.000 and τ = 0.765; P = 0.000), maximum percent agreement (77.19%) and a substantial kappa value of agreement (κ = 0.62) with the SBR's grading system. All the six cytological grading systems correlated with histological grading strongly and positively. In multiple regression analysis, all of the cytological parameters of Robinson's system except cell size and nucleoli had significance in predicting the final cytological grade.Conclusions:Robinson's grading system is simple, more objective and reproducible, and demonstrated the best concordance with histological grading. So, Robinson's system should be used routinely for breast carcinoma aspirates.