Role of FNAC in the Diagnosis of Breast Carcinoma, its Correlation with Histopathology and its Prognostic Importance

ABSTRACT

Breast carcinoma is the most common malignant tumor and the leading cause of carcinoma death in women. With an annual incidence of approximately 1, 44,000 new cases of breast cancers in India, it has now become the most common female cancer in urban India and the second commonest in the rural Indian women. Nottingham applied histological grading system,and Robinson applied cytological grading system, which are one of the established methodologies to determine the histological and cytological grade of the tumor. By using these prognostic factors from pathological reports, the prognosis of the patient can be estimated individually. Aim: To analyze cytological and histological grading and their correlation along with tumor size and lymphnode status in breast carcinomas and its prognostic importance. Methods: All patients presenting with palpable breast lesions were subjected to an FNAC procedure after a detailed history, general physical and local examination. After performing fine needle aspiration diagnosis of various breast lesions were made on the basis of morphological and cytological findings and cytological grading for the malignant breast lesions was done. It was followed by excision biopsy, mastectomy, and cytohistological comparison was done to assess the efficiency and accuracy of cytological grading done after fine needle aspiration. Results: The most common type found in study was Ductal carcinoma (not otherwise specified) seen in 95.2% cases. The maximum no. of cases i.e. 36 (44.45%) were found in upper outer quadrant. all patients (100%) presented with complaint of lump in the breast. On assessing all 6 features, the maximum number of cases were in grade- II i.e. 48 (59.3%). A significant agreement was seen between cytological and histological grades. Conclusion: Assigning a cytological grade of breast carcinoma aspirates can be done with little effort, is reproducible and with rare exceptions depending on sample limitations correlates precisely with the histological grade. The tumor grading can be used as a very good prognostic and predictive marker for breast carcinomas.