Author(s): Phukan JP, Sinha A, Deka JP, Phukan JP, Sinha A, Deka JP, Phukan JP, Sinha A, Deka JP
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Abstract BACKGROUND: Grading of breast carcinoma on fine needle aspiration cytology (FNAC) is beneficial for selecting patients for neoadjuvant chemotherapy. AIMS: To grade the breast carcinoma on FNAC using Robinson grading system and to assess the concordance of cytological grading (CG) with histological grading (HG) using Elston-Ellis modification of Scarff-Bloom-Richardson grading system. MATERIALS AND METHODS: The study was conducted for 1-year, comprising of 50 female patients attending outpatient departments (OPD) as well as admitted in various surgical wards of a teaching hospital, diagnosed as breast carcinoma. FNAC smears were stained with May-Grunwald-Giemsa and Papanicolaou (Pap) stains and CG was done using Robinson system on Pap stained smears. The results were compared with HG system after resection of tumors. RESULTS: Of 50 cases, 14 (28\%) cases were graded as grade I, 24 (48\%) grade II, and 12 (24\%) grade III by CG, whereas 9 (18\%), 28 (56\%) and 13 (26\%) cases were graded as grade I, II and III by HG. The result showed overall 72\% concordance of CG with HG, with grade II and grade III showing highest degree of concordance (83.33\%), which is comparable to previous studies. Kappa measurement showed a higher degree of agreement in high-grade tumors compared with low-grade tumors (0.73 in grade III, 0.53 in grade II and 0.39 in grade I). CONCLUSION: Cytological grading is comparable to HG in majority of cases. Because neoadjuvant chemotherapy is becoming increasingly popular as primary treatment modality of breast cancer, CG could be a useful parameter in selecting the mode of therapy and predicting tumor behavior.
This article was published in South Asian J Cancer
and referenced in Journal of Integrative Oncology