To Evaluate The Usefulness of Cytological Grading of Breast Cancer as a Predictor of Lymph Nodal Metastasis.

ABSTRACT

In a 5-year retrospective and 1-year prospective study a total of 110 fine-needle aspiration cytology (FNAC) cases of breast cancer were studied. These were graded according to Robinson's and Mouriquand's grading methods and relationship between grading and lymph node metastasis; cell dissociation parameter of Robinson's grading and lymph node metastasis evaluated. Of the 110 cases graded by Robinson's method, Grade I tumours had lymph node involvement in 3.57% of cases. Grade II and Grade III tumours had lymph node involvement in 6.52% and 47.22% of cases respectively where as when graded by Mouriquand's method, Grade I tumours had lymph node involvement in 3.57% of cases. Grade II and Grade III tumours had lymph node involvement in 7.14% and 42.5% of cases respectively. Although both grading systems showed significant relationship with lymph node involvement but Robinson's grading was a much better predictor of lymph node metastasis. Our study showed that greater cell dissociation was associated with higher incidence of regional lymph node metastasis. A highly significant relationship was observed between cell dissociation and lymph node involvement (p=0.00000). We conclude that cytological grading of breast cancers is a strong predictor of lymph nodal metastasis and greater cell dissociation is associated with higher incidence of regional lymph node metastasis.