Robinson’s Cytological Grading on Aspirates of Breast Carcinoma and Correlation With Bloom-Richardson’s Histological Grading

Abstract

BACKGROUND Breast carcinoma is one of the most common cancer of women. Fine-Needle Aspiration Cytology (FNAC) is widely used, most convenient, quick and common preoperative diagnostic modality in breast lesions. Cytological grading on aspirates of breast carcinoma is a very useful tool for surgical manoeuvre and prognosis. The aim of the study is to study the correlation of cytomorphological Robinson's grading with modified Bloom-Richardson's histopathological grading of breast carcinoma. MATERIALS AND METHODS In the present study, 140 cytologically malignant breast tumour cases were included in the study and out of which, 90 cases correlated with histology after mastectomy. FNA was performed with 22-24 gauze needle and smears were stained with Haematoxylin and Eosin, Papanicolaou and May-Grunwald-Giemsa and evaluated for cytological grading according to Robinson's grading system. H and E stained histosections were graded according to Bloom-Richardson's grading system and comparison were done between the two. RESULTS Robinson's cytological grading correlated well with Bloom-Richardson's histopathological grading. The concordance rate between cytology and histology of Grade I, Grade II and Grade III tumours were 84.61%, 79.16% and 87.5%, respectively. Overall, concordance was found to be 83.6%. The Kappa value showed 95% confidence level. Thus, the strength of agreement between two grading systems considered to be fair. The P value on chi-square analysis showed <0.0001, which was considered statistically significant. Hence, the cytological grading is comparable with histological grading. CONCLUSION Robinson's cytological grading of breast carcinoma correlates well with Bloom-Richardson's histomorphological grading system. Hence, cytological grading in FNAC smears can be used as a prognostic factor for choosing the newer treatment modalities.

Correlative study of cytological features in grading of invasive breast carcinoma

“…[ 2 3 ] Cytological studies, on fine-needle aspirated breast carcinoma material, have developed a number of scoring systems with results similar to those obtained from histological sections. [ 4 5 6 7 8 9 10 ]…”

“…who had used the same grading system as us. [ 4 6 10 ] Moroz et al . and Khan et al ., using their respective cytological grading systems, have demonstrated similar results.…”

“…Robinson and several other authors have shown that this method can provide additional information about intrinsic features of a tumor and have proposed cytological grading systems with results similar to histologic grades. [ 4 5 6 7 8 9 10 ] Nuclear grade, evaluated in histologic grading systems, is based on cytological criteria and its application can intuitively be adapted to cytological material.…”