Evaluation of scoring system in cytological diagnosis and management of breast lesion with review of literature.

ABSTRACT

Background: Fine needle aspiration cytology (FNAC) breast is generally considered as a rapid, reliable, and safe diagnostic tool to distinguish non-neoplastic from neoplastic breast lesions. Masood's Scoring Index has been proposed to help in sub-grouping of breast lesions so as to help in surgical management. Aims: To assess the accuracy of Modified Masood's Scoring Index (MMSI) in the diagnosis of benign and malignant breast lesions in patients with palpable breast lump, and review of literature. Settings and Design: A prospective study from a tertiary care center. Material and Methods: This prospective study included a total of 100 cases, both females and males, with palpable breast lump, in the age range of 10-80 years, over a period of 2 years from January 2007 to 2009, who underwent FNAC. They were cytologically grouped into five categories as suggested by Masood et al, and confirmed by histopathology. Results: Evaluation of Masood Scoring Index led to modification (Modified Masood Scoring Index; MMSI) by shifting score 9 from Group I to Group II, thus increasing the diagnostic accuracy of the breast lesions. Conclusions: MMSI was found to be a useful, easily reproducible scoring method of breast lesions to improve diagnostic accuracy of nonproliferative breast disease and proliferative breast disease without atypia cases, as the prognosis and treatment of these cases varies.