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

Dr. Manjula Choudhury; Dr. Rajlakshmi Dutta

Volume : IX, Issue : I, January - 2020

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 east 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 east who underwent FNAC and mastectomy for east 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. Kappa–coefficients 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 east carcinoma aspirates.