Role of Cytological Grading in Breast Cancer Prognosis and its Histo-pathological Correlation

Abstract

Objective: Breast carcinoma is the most common cause of death in females globally, which should be detected early and treated promptly. This study aims at establishing Fine Needle Aspiration Cytology (FNAC) as an individual parameter in diagnosing & grading carcinoma breast and to correlate cytological grading with the histopathological grading done post-operatively. Materials & methods: We present here, a series of 44 cases, clinically suspected of carcinoma breast, presenting with hard, painful breast lump with or without axillary lymphadenopathy, sent for cytological examination to our department. Aspiration was done, following using 20G needle and smears were stained with Haematoxyline & Eosin, Papanicolau, and May-Grunwald-Giemsa. Results: The stained smear showed highly pleomorphic ductal cells in large number forming dyscohesive sheets & also lying singly. Cells had nuclei with hyperchromasia, irregular nuclear margin, open chromatin & conspicuous nucleoli. The diagnosis of carcinoma breast was offered and cytological grading was done according to Robinson's nuclear grading system in all cases. Urgent biopsy was also however, recommended. The mastectomy specimens of these patients, when grossed & stained with Haematoxyline & Eosin proved the cytological diagnosis conclusive and cytological grading of the tumors concordant in 80% of the cases. Higher cytological grades showed increased nodal metastasis. Conclution: So, early diagnosis & precise grading with the help of FNAC itself can prove to be a very good informative tool & prognostic indicator, leading to commencement of early treatment & can prevent many untimely deaths in future.