Cytological grading of duct cell carcinoma, NOS of breast and its correlation with histological grading.

ABSTRACT

Fine needle aspiration cytology is a widely practiced technique in the diagnosis of breast carcinoma and it is the only, diagnostic procedure performed before definitive treatment, at most institutions. While the histological grading of Duct Cell Carcinoma (DCC), NOS is done routinely in many centers worldwide the cytopathological grading of DCC, NOS is not commonly done. Grading of breast carcinoma, while the tumour is still in vivo, would be the most ideal and desirable situation, as it would be helpful in the selection of appropriate therapy for the patient. This study was undertaken with the aim to determine the grade of DCC, NOS by simple cytological scoring system as a method of predicting histological grade. We selected 80 cases of DCC, NOS which were initially diagnosed by Fine Needle Aspiration Cytology (FNAC) with subsequent histological confirmation. For cytological grading Papanicolou's stained smears and for histological grading Haematoxylin and Eosin stained sections were examined under light microscope. For histological grading Scraff Bloom Richardson's grading and for cytological grading Robinson's grading were followed. In both system grading were grade I, grade II and grade III of DCC, NOS. On cytological grading 39 (48.8%) cases were grade-I, 38 (47.5%) cases were grade-II and 3 (3.8%) cases were grade-III. On histological grading 33 (41.3%) cases were grade-I, 39 (48.8%) cases were grade-II and 8 (10%) cases were grade-III. In this study cytological grade correlated with histological grade in 69 (86.3%) cases. For grade-I tumour, sensitivity was 96.96%, efficiency was 94%. For grade-II tumour the sensitivity was 87.18% and efficiency was 77%. For grade-III tumour the sensitivity was 37.50% and efficiency was 23%. The overall accuracy was 96.3%. Significant association between histological and cytological grading of breast carcinoma, NOS was noted. Our observations in this study revealed that grading of duct cell carcinoma, NOS on FNAC material can be a useful in preoperative assessment of DCC, NOS prognosis and can be useful as an alternative to histological grading when neoadjuvant therapy is planned.