Role of cytological grading in the management of breast lump.
OBJECTIVE
To evaluate the fine needle aspiration (FNA) smears of the breast lumps using the cytological evaluation system (C1 to C5) as practiced in the National Breast Screening Programme in the UK.


METHODS
A descriptive study on patients with a breast lump.


METHODS
The study was conducted at Pathology Department of Combined Military Hospital Kharian Cantt, from February, 2000 to February, 2001. SUBJECTS AND METHODS Clinical details of all the patients was recorded. FNA of the patients was performed and smears were stained with haematoxylin and eosin, papanicolaou and May-Gruenwald-Giemsa stains. The smears were evaluated according to C1 to C5 system. The results of cytology were compared with the surgical biopsy specimens.


RESULTS
A total of 75 patients of lump breast were included in the project. The age range was 13-75 years with a peak incidence in the 3rd decade. There were 70 (93.3%) females and 5 (6.6%) male cases. Of the total 75 cases, 7 were designated C1, 45 C2, 5 C3, 7 C4 and 11 C5. In surgical biopsies, all the 45 cases designated as C2 proved to be benign with fibroadenoma and fibrocystic change as predominant lesions. All 11 designated C5 proved to be malignant; whereas, of the 5 cases labeled as C3, 4 were benign and one was malignant and out of seven C4 cases, 5 came out as malignant and 2 proved benign.


CONCLUSIONS
The fine needle aspiration of lump breast has a sensitivity of 94.1%, specificity of 96.0% and accuracy of 95.5%. The C1-C5 grading system is practical, flexible, gives room for expression of opinion by cytopathologist and easily interpreted by clinicians.
Mehmood
Aamer
A
Department of Histopathology, Combined Military Hospital, Kharian Cantt, Pakistan.
Ahmed
Mumtaz
M
Jamal
Shahid
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000473:pathology; D002648:Child; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity