Typing and grading of cytological category C5 breast lesions.
OBJECTIVE
To determine the tumour type, cytological grade and nuclear grade on fine-needle aspiration smears in cytological category C5 breast lesions and compare them with histopathological findings.


METHODS
Cross-sectional, cohort.


METHODS
Department of Histopathology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from January to December 2002.


METHODS
Out of all patients referred to AFIP, Rawalpindi for fine-needle aspiration of breast masses, those adjudged C5 (malignant) were chosen for this study. History, clinical details and mammographic findings were noted. Aspirated smears were examined and an attempt was made to ascertain tumour type, cytological grade and nuclear grade. On excision of these lesions, the cytological findings were compared with those on paraffin-embedded histological sections.


RESULTS
A total of 71 patients were included in this study. Of these, 64 (90.14%) were cytologically diagnosed as ductal carcinoma, 4 (5.63%) lobular carcinoma, 2 (2.82%) mucinous carcinoma and 1 (1.41%) as medullary carcinoma. Seventy (98.60%) tumours were correctly typed on aspiration smears. Sixty-eight (95.77%) cases were cytologically graded with accuracy. Nuclear grading was even better on cytology and, excluding one malignant lymphoma, all 70 (100%) smears were assessed correctly.


CONCLUSIONS
Overall efficiency of the tumour typing, cytological grading and nuclear grading on aspirated material turned out to be quite accurate. In expert hands, cytological examination can be of great help in pre-operative planning and in cases where tumour morphology in paraffin-embedded material has been distorted by neo-adjuvant therapy prior to excision.
Zafar
Nadeem
N
Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi. xaphre@amcolians.every1.net
Jamal
Shahid
S
Mamoon
Nadira
N
Luqman
Muhammad
M
Anwar
Masood
M
D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D009367:Neoplasm Staging / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies