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Comparative Study of Cytomorphological Robinson’s Grading for Breast Carcinoma with Modified Bloom-Richardson Histopathological Grading

DOI: 10.1155/2013/146542

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Abstract:

Objective. To study the correlation of cytomorphological Robinson’s grading for breast cancers with a modified Bloom-Richardson histopathological grading. Materials and Methods. One hundred sixteen cytologically malignant breast tumour cases were included in this study and correlated with paraffin embedded sections. Breast lumps were varied from less than 1?cm to 11?cm in greatest dimension. FNA was performed from different sites of the breast lump, and smears were stained with Giemsa and H&E stain and evaluated for cytological grading according to Robinson’s grading system. Paraffin embedded tissue sections were stained with hematoxylin and eosin stain and graded according to modified Bloom-Richardson grading system. Comparison between these two grading systems was done. Results. Cytologically grade I, grade II, and grade III cases were 13.8%, 64.65%, and 21.55%, respectively. Histologically 25%, 54.31%, and 20.69% cases were grade I, grade II, and grade III, respectively. Concordance rate between cytology and histology of grade I, grade II, and grade III tumors was 75%, 70.67%, and 60% respectively. The absolute concordance rate was 68.97%. Conclusion. In the era of multiple treatment modalities and neoadjuvant therapy, cytological grading can be used as a prognostic factor for better management of patients. 1. Introduction Breast cancer is the commonest cancer in urban Indian women and the second commonest cancer in the rural women next to cervical carcinoma. Due to general indifference towards the health of females in the Indian society, lack of an organized breast cancer screening program, and paucity of diagnostic aids, majority of breast cancers are diagnosed at a relatively advanced stage [1]. Since last decade, cytodiagnosis has gained importance due to rapid results at low cost and may help in early diagnosis in country like India. FNAB is a reliable method for the initial evaluation and diagnosis of palpable masses of the breast. In addition, it also has the ability of providing necessary prognostic/predictive information, particularly for patients that may undergo neoadjuvant therapy [2]. The standard prognostic factors, recognized by the National Cancer Institute in 1990, include lymph node status, tumor size, nuclear grade, steroid receptor content, tumor type, and cellular proliferation rate and recommend that for patients who undergo preoperative chemotherapy or radiotherapy, breast fine-needle aspirates can be used to provide prognostic information [3]. The grading of breast cancer on fine-needle aspiration help in understanding of the

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