Efficacy of Modified Masood Scoring System (MMSS) in Cytological Diagnosis of Breast Lesions

Abstract

Introduction: Fine-needle aspiration cytology (FNAC) breast is generally considered a reliable diagnostic tool to distinguish non-proliferative from proliferative breast lesions. Nevertheless, differentiating these breast lesions on FNAC poses a diagnostic challenge. Modified Masood Scoring System (MMSS) based on cytomorphological examination has been used to help in differentiating these lesions.Material and methods: A total of 67 patients were included in this prospective study done from November 2012 to May 2014 and the breast lesions were cytologically categorized by conventional and as per MMSS criteria, followed by comparison to a histopathological examination, which was taken as a gold standard. Relevant frequencies and proportions were calculated along with the sensitivity and specificity of the MMSS.Results: The age of the patients ranged from 15 to 85 years with a mean age of 44.3 ± 14.8 years. Females predominated in the study and right-sided breast lesions were more common compared to the left side. Overall diagnostic specificity (100%) and accuracy (97%) were higher using MMSS as compared to conventional cytology in which case specificity was 83.6% and accuracy was 82.1%.Conclusions: Cytological grading system based on MMSS allowed accurate and reproducible diagnosis compared to the standard histopathological diagnosis. It is essential to differentiate non-proliferative lesions from proliferative lesions as the line of treatment and prognosis varies.

Evaluation of breast cytology by applying modified Masood’s scoring system

“…In the present study, cytology and MMSI concordance in Category I is 72.22% (Table 3), histopathological and MMSI concordance was 23.07% (Table 4), because we received minimum number of biopsy reports in this Category as compared to various studies by William et al, 19 found that the concordance between MMSI and histopathology is 66.6% Cherath and Chithrabhanu 16 found that the concordance between MMSI and histopathology is 92.68%.…”

“…Shah and Code 18 found that the concordance between MMSI and histopathology is 95.45%. William et al, 19 found that the concordance between MMSI and histopathology is 100%.…”

“…Total Score Category-I-Non-proliferative breast disease 6-8 Category-II-Proliferative breast disease without atypia 9-14 Category-III-Proliferative breast disease with atypia 15-18 Category-IV-Carcinoma in situ/Carcinoma[19][20][21][22][23][24] …”