The Cytological Grading of Malignant Neoplasms of The Breast and Its Correlation With The Histological Grading

Abstract

Background and Objectives: Breast carcinoma is one of the leading causes of malignancy in females. The diagnosis of breast carcinoma is often made by fine needle aspiration cytology. Nuclear grading is an important prognostic factor. It is important to grade breast carcinomas, which will provide valuable information to the treating oncologists to plan their management. The purpose of this study was to compare the cytological grading and typing with the histological grading and typing and the regional lymph node metastasis.Methodology: This retrospective and prospective study was done on 60 cases with malignant and suspicious diagnoses on FNAC, which had histopathological correlations, from January 2004 to December 2007. The cytological grading was done by Robinson's Method and the histopathological grading was done by the modified Scarff Bloom Richardson method. Cytological and histological typings were also done. The statistical analysis was done by using the SPSS software: The Chi square test was used and a contingency tale analysis (cross tabs procedure) was also done. Results:The cytohistological grading correlation was accurate in 7 cases (100%) of grade 1, 22 cases (71%) of grade 3 and 9 cases (42.9%) of grade 2 cancers. The accuracy was 62.7% (P < 0.001). A higher cytological grade was associated with a nodal metastasis. (cc : 0.399, P < .006) The cytological typing was accurate in 44 cases out of the 60 cases. Interpretation and Conclusion:The cytological grade correlated well with the histological grading accuracy (62.7%) and a higher grade was associated with a nodal metastasis (P < 0.006), Hence the cytological grading and typing should be routinely incorporated in the cytology reports and they can be of great value in guiding the choice of the treatment protocols.Vidya VasudeV, Rangaswamy R., geethamani V. InTROduCTIOnBreast cancer is the second most common malignancy in females in India [1]. Recent studies have shown that the incidence of breast cancer is increasing and shifting towards the younger age group [2]. Hence, any breast lump, whether it is benign or malignant, is a source of anxiety for the patient as well as for the treating doctor [3].Breast cancer is a malignant disease with a heterogenous prognosis. Evaluation of the possible prognostic parameters is a growing interest. Assessment of the biological aggressiveness of the cancer without removing it, would be valuable.The value of the histological typing and grading has been well established [4]. Because the neoadjuvant therapy has become increasingly popular as the primary medical treatment of breast cancer, much attention is being focused on grading the tumours, based on the FNA cytology. Such a grading would allow the assessment of the tumour in situ and so the most suitable treatment could be selected before the primary surgery. Also, the morbidity which is associated with the overtreatment of low grade tumours could be avoided [5].FNAB is not only helpful in the diagnosis and the further planning of the treatment, but it is ...

Correlation between 3 T apparent diffusion coefficient values and grading of invasive breast carcinoma

“…NGS provides a simple, inexpensive and easily applicable picture of the biological characteristics of the tumor. Histological grade can accurately predict evolution and response to therapy as well as prognosis [9].…”

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“…3 The inter observer and the intra observer reproducibility are the key factors in grading system. 5 Robinson's grading was selected because of easy reproducibility and is more objective. 3 In the current study the absolute concordance rate between Robinson's cytological grading system and SBR histopathological grading system was 82%, which issimilar to study conducted by Rekha 15,16 In the present study, lack of concordance between cytological and histopathological grading in 7 out of 60 cases could be due to inter observer subjectivity and presence of tumor heterogeneity in the same tumor.…”

Poor Correlation of Histologic Parameters Between Biopsy and Resection Specimen in Early Stage Oral Squamous Cell Carcinoma

“…In urologic, colorectal, and gynecologic cancers, histologic characteristics guide further treatment. [24][25][26][27][28] In head and neck cancers, tumor diameter, thickness, and nodal spread are the most important determinants for therapy. 14 Increasing tumor infiltration depth is positively associated with neck nodal metastasis.…”