Abstract
Background. Fine-needle aspiration cytology plays a major role in the primary diagnosis of breast carcinoma. Cytological grading of the smears can provide valuable prognostic information and aid in planning the management options. Aim. To evaluate various 3-tier cytological grading systems and to determine the best possible system which is reliable and objective for use in routine practice. Materials & Methods. 72 fine-needle aspiration smears of breast carcinomas were graded by two pathologists and compared with the histologic grading by Nottingham modification of Scarff-Bloom-Richardson method. Concordance and correlation studies were done. Kappa measurement of interobserver agreement was also done. Results. Robinson's method showed a better correlation (77.7%) and substantial Kappa value of agreement (κ = 0.61) with Bloom Richardson's histological grading method in comparison to the other methods, closely followed by Fisher's method. Fisher's method showed better interobserver agreement (84.7%, κ = 0.616) compared to the other systems. Conclusions. Robinson's method of cytological grading in fine-needle aspiration smears of breast carcinoma is simpler, multifactorial, and feasible, hence being preferable for routine use according to our study.
Highlights
In India, breast cancer is the second most common malignancy in females, next to cervical cancer [1]
Fine needle aspiration (FNA) cytology is used for the preoperative diagnosis of breast malignancies and its role in determining the prognosis is being studied by various authors
Numerous two-tier and three-tier systems have been proposed for the cytological grading of breast tumors, but no single system is currently adapted for use in the routine evaluation of cytological aspirates of breast carcinoma
Summary
In India, breast cancer is the second most common malignancy in females, next to cervical cancer [1]. Fine needle aspiration (FNA) cytology is used for the preoperative diagnosis of breast malignancies and its role in determining the prognosis is being studied by various authors. Fine-needle aspiration cytology plays a major role in the primary diagnosis of breast carcinoma. 72 fine-needle aspiration smears of breast carcinomas were graded by two pathologists and compared with the histologic grading by Nottingham modification of Scarff-Bloom-Richardson method. Robinson’s method showed a better correlation (77.7%) and substantial Kappa value of agreement (κ = 0.61) with Bloom Richardson’s histological grading method in comparison to the other methods, closely followed by Fisher’s method. Fisher’s method showed better interobserver agreement (84.7%, κ = 0.616) compared to the other systems. Robinson’s method of cytological grading in fine-needle aspiration smears of breast carcinoma is simpler, multifactorial, and feasible, being preferable for routine use according to our study
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