Comparative Study Of Fine Needle Aspiration Cytology And Histopathology In Grading Breast Carcinoma

Abstract

Background : Grading of tumors in Fine Needle Aspiration Cytology (FNAC) would be useful particularly for patients with advanced stages of the disease who may receive primary chemotherapy or radiotherapy followed possibly by surgery. Objectives :

1) To assess the cytological grade in fine needle aspiration cytology smears of breast carcinomas. 2) To compare the cytological grade with histological grade in surgical specimens and biopsies of axillary lymph nodes. Methods : The study included 38 female patients of invasive ductal carcinoma diagnosed cytologically. Cytological grading of smears was done by Taniguchi grading system. Respective surgical specimens were processed and histological grading was done by Scarff Bloom Richardson grading method. The lymph nodes were also studied for detection of metastasis. Results : Based on Taniguchi grading method the cases were classified into grade I ( 5.26% ), grade II ( 42.11% ) and grade III ( 52.63%). Based on Scarff Bloom Richardson grading method the cases were classified into grade I ( 2.63% ), grade II ( 52.63%) and grade III ( 44.74%). Total Concordance between the two grading systems was seen in 78.95% of cases. Positive correlation was seen between the two grading systems. Lymph node metastasis was seen in 52.63% of cases which was maximum in grade III cases.

x Conclusions : Cytological grading allows prognostic evaluation of breast carcinoma along with diagnosis without additional morbidity or expense to the patient. Taniguchi’s grading system is simple, takes little time, is reproducible and correlates precisely with the histological grade. Hence cytologic grade should appear in FNAC reports of ductal breast carcinoma for proper management.