A single point cytological grading system for breast carcinoma
Journal Title: Medpulse International Journal of Pathology - Year 2019, Vol 9, Issue 3
Abstract
Background: Cytological grading on fine needle aspirates of breast carcinoma is an important parameter in determining the therapy and prognosis in the era of neoadjuvant preoperative therapy. All the present grading systems use more than one parameter for arriving at a grade. Inspite of numerous grading systems, none of them is acceptable as gold standard. Histological grading of Scarff-Bloom Richardson method cannot be applied convincingly for cytological aspirates in view of various parameters associated with it. In core biopsies which are positive for malignancy SBR grade cannot be applied due to heterogeneity of tumour. In such cases only the nuclear component of SBR grade applied and a nuclear grade is given. With this background an attempt has been made to apply only the nuclear pleomorphism component of SBR grading system to cytological aspirate smears and correlate the same with histopathological grade, ER, PR and Her2 neu status. Objective: To grade breast carcinoma aspirates based on single parameter of nuclear pleomorphism and to correlate different cytological grades with their corresponding histopathological grade, ER, PR and Her2 neu status. Materials and methods:50 cases of histologically proven carcinoma breast cases were reviewed and were categorized into one of the three grades depending upon nuclear pleomorphism as given by Nottingham’s modification of SBR grading. These cytological grades were then correlated with corresponding histopathological grade, ER, PR and Her2 neu status. Results: Out of 50 cases, 9 cases (18%) were grade 1, 29 (58%) were grade 2 and 12 cases (24%) were grade 3. 66.6%, 79.3% and 58.3% of the cases showed a good correlation with corresponding histopathological grade. Among the hormone receptor and Her2/neu status, 42% of grade 3 tumors were triple negative. 52% of grade 2 tumors showed ER, PR positivity whereas none of the tumors of grade 1 were Her2 neu positive. Conclusion: Single point cytological grading showed good correlation with histopathological grading and ER, PR, Her2 neu status. This can be routinely used in cytology reporting for breast cancer aspirates.
Authors and Affiliations
Hemalatha J, Deepak Kumar B, Srinivasa Murthy V, Padmapriya Kasukurti
Keywords
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- EP ID EP536692
- DOI 10.2661/105937
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