Evaluation of Nuclear Grading on FNAC Smears and Tissue Sections in Carcinoma Breast

Abstract

Introduction: Fine needle aspiration is a very useful and widely used diagnostic tool for palpable and non palpable breast lumps. It has a sensitivity of 87% and positive predictive value of nearly 100%. Nuclear grading can also be done on FNAC smears. The present study has been undertaken to correlate the morphological features of FNAC and histological grading systems. Aims and Objectives: To asses and compare cytohistomorphological nuclear grading in breast malignancies. To qualitatively estimate the nuclear grading on cytology aspiration and cytologic grading. Materials and Methods : 100 patients were studied during the period of 5 years ranging from 2005 to 2010 who presented to the Department of Surgery with an palpable breast lump. Both FNAC and histology was done. Nuclear grading system of Robinson et al was used for cytological evaluation and Eiston and Ellis modified Bloom- Richardson method was used for histological grading. Observations: Study comprised of 100 cases of duct carcinoma, 97% of the patients diagnosed on cytology were confirmed on histological examination. There were 30 grade I tumors, 46 grade II tumors and 21 grade III tumors. Conclusions: Histological and cytological grading system were comparable to each other in predicting the grade of the tumor probability value >0.05. Sensitivity, specificity and accuracy were 98.9%, 100% and 99% respectively.