Role of cytologic grading in prognostication of invasive breast carcinoma

Khan, Nazoora; Afroz, Nishat; Rana, Farah; Khan, M Zareen

doi:10.4103/0970-9371.55224

Cited by 30 publications

(42 citation statements)

References 16 publications

(20 reference statements)

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“…[26][27][28] On correlating the cytological grading by RCG method with histopathology the concordance rate ranged from 56.9% to 89.1% by various studies. [9,27,[29][30][31][32][33][34][35][36][37] Phukan JP et al and Nggada HA et al, had found the overall sensitivity and specificity of 72.2% & 97.5% and specificity of 100% & 98.7% in cytological grading of breast carcinoma respectivily. [33,3] In present study, which includes both benign and malignant breast lesions has a overall sensitivity of 86% and specificity of 50%.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods

Rekha¹,

Nandini²

2015

SJCM

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Abstract:Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index (MCI) with various other cytology grading methods and histopathology. Result: Modified MCI has over all concordance rate of 86%, sensitivity of 86%, specificity of 50%, positive predictive value (PPV) of 93% and negative predictive value (NPV) of 30%. Multiple regression analysis revealed an r 2 value of 60%, which was significant. The p-value of anisonucleosis, nucleoli and chromatin pattern were 0.001, 0.05 and 0.02 respectively, which was significant (p-value less than 0.05). Conclusion: Modified MCI will help the cytopathologist to accurately delineate both benign and malignant neoplastic breast lesions into respective categories. This in turn will help the treating surgeon to plan the treatment modality of the patients with lump in the breast. The study recommends that modified MCI method to be routinely incorporated for evaluation of all lump in the breast.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods

Rekha¹,

Nandini²

2015

SJCM

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“…Khan et al 10 showed a concordance value of 84%. A study by Milentijevic et al 11 also show a concordance value of 81%.…”

Section: Correlation Of Lymph Node Status With Tumour Sizementioning

confidence: 99%

“…These studies coincide with the present study. Khan et al 10 states that higher concordance was found among Grade 1 tumours (92.3%). Several studies states that concordance was high among high-grade tumours.…”

Section: Correlation Of Lymph Node Status With Tumour Sizementioning

confidence: 99%

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Cytological Grading of Ductal Carcinoma of Breast in Fine Needle Aspirates and Its Correlation With Histological Grading

K¹,

Nilavu²

2017

jemds

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BACKGROUNDGrading of fine needle aspirates of breast carcinoma is useful for selection of appropriate therapy, especially for planning neoadjuvant chemotherapy.The aim of this study is to evaluate the cytological grading by Robinson method in FNAC samples and to correlate it with the well-known prognostic factor. Histological grading system proposed by Nottingham Modification of Bloom-Richardson. The cytologic grading system was also correlated with the axillary lymph node status. MATERIALS AND METHODSThis descriptive study was done on fifty female patients with breast lump in Department of Pathology in Coimbatore Medical College. Cytological samples were stained using H and E stain and Papanicolaou stain. Cytologic grading was done by Robinson method and compared with Nottingham modification of Scarff-Bloom-Richardson method histologic grading system. RESULTS Most of the tumours were Grade 2 tumours (46%).The concordance between cytological grade and histological grade was 86%, nearly 43 out of 50 cases. The remaining 7 cases (14%) showed discrepancy. Among these cases, five were upgraded and two were downgraded. The association between cytological grade and histological grade were statistically significant (p < 0.05). The Lymph node positivity was noted among 37.5%, 52.17% and 72.7% of Grade 1, 2 and 3 tumours respectively. High grade tumours show increased nodal positivity. The association between cytological grade and lymph node status was not statistically significant (p > 0.05). Most of the tumours were T2 (2 -5 cm). The association between tumour size and cytologic grade was not statistically significant (p > 0.05). Most of the tumours were located in outer quadrant 50%, higher grade tumours in central quadrant. CONCLUSIONThis concludes that cytological grading should be included in all FNAC reports of ductal carcinoma of breast, so that appropriate decision can be made regarding the neoadjuvant chemotherapy can be taken and overtreatment of low-grade carcinomas can be avoided. Fine needle aspiration cytology is being increasingly used to determine the benign and malignant nature of the lesion. 2 Attempts have been made to determine various prognostic parameters on FNA material to determine the best therapy. 3 KEYWORDS

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“…The breast carcinomas were graded cytologically by Robinson's Cytological Grading system (Table 1).Histological grading of H&E stained tissue sections was done by Modified Scarff Bloom Richardson method (Table 2). Scores: Grade I (well differentiated) 3-5; Grade II (moderately differentiated) 6-7; Grade III (poorly differentiated) [8][9] Concordance was calculated between cytological and histological grading systems for all the grades. Kappa statistical analysis was done to see the strength of agreement between the two grading systems.…”

Section: Methodsmentioning

confidence: 99%