COMPARATIVE EVALUATION OF THREE CYTOLOGICAL GRADING SYSTEMS ON FINE-NEEDLE ASPIRATES OF BREAST CARCINOMA

Dr. Manjula Choudhury, Dr. Rajlakshmi Dutta

Abstract


BACKGROUND: Assigning grades to breast carcinoma on Fine-needle aspirates provides prognostic information and guides optimal therapy.
AIM: The present study was undertaken to evaluate three cytological grading systems to determine which corresponds best to histological
Modified Bloom Richardson grade.
MATERIALS AND METHODS: 44 patients of Infiltrating duct carcinoma of breast who underwent FNAC and mastectomy for breast
carcinoma were graded cytologically by Robinson grading, Fisher's modification of Black's grading system and Howell's modification of SBR
grading; followed by histological grading. Correlation between cytological grades and histological grades was determined using kappa-coefficient
and absolute concordance values.
RESULTS: All three systems correlated strongly with histological grading with absolute concordance of 88.6%, 84.1% and 81.8% for Robinson,
Fisher's and Howell's systems respectively. The Kappa-coefficients were 0.88 for Grade I, 0.86 for Grade II and 0.65 for Grade III tumors by
Robinson's grading. Fisher's grading showed Kappa-coefficients of 0.68 for Grade I, 0.96 for Grade II, and 0.50 for Grade III tumors. Kappacoefficients
were 0.38 for Grade I, 0.78 for Grade II and 0.84 for Grade III tumors in Howell's system.
CONCLUSION:Robinson's grading system is simple, more objective and demonstrates best concordance with histological grading. So,
Robinson's system should be used routinely for breast carcinoma aspirates


Keywords


Breast Carcinoma; Cytological Grading; Fnac; Prognosis.

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