Cytological Grading on Aspirates of Breast Carcinoma and Its Correlation with Histopathological Grading

Author(s): Karuthedath Areeppurath Mana Jayasree1 , Mini B.2 , Kamala V. V.3

BACKGROUND A palpable breast lump is always a cause of concern to the patient. Hence, accurate pathological diagnosis is crucial for further management and to evaluate the outcome. In this, FNAC plays an incredible role along with clinical examination and mammography, all being a part of “triple diagnosis” as it predicts the histopathological picture before deciding patient management. METHODS The study was conducted in the Department of Pathology, Government Medical College, Thrissur. Fifty-five patients with a palpable breast lump in the age group 20 to 70 years were selected. FNAC was done and smears were stained with Papanicolaou and Romanowsky stains. Cytological grading was done by Robinson's method. The patients were followed up to surgery and the results were compared with histological grading after resection of tumours. RESULTS Of 55 cases, 50.9 % (28) cases were graded as grade 1, 36.4 % (20) as grade II, and 12.7 % (7) as grade III by cytological grading. Whereas, 30.9% (17) cases were Grade I, 54.5% (30) grade II, and 14.5 % (8) grade III on histological grading. Overall concordance with cytological grading was 78.18% with a kappa value of 0.651 and a higher degree of concordance in grade II and III. CONCLUSIONS Cytological grading of breast carcinoma by Robinson’s method has been found to be easier and better because of most objective set criteria and easy reproducibility. A conscious effort to include cytological grading in FNAC reports should be made mandatory so that an appropriate decision regarding neo adjuvant therapy can be started.