title: Correlation of morphological markers of chromosomal instability in fine needle aspiration cytology with grade of breast cancer.
abstract: OBJECTIVE
  The aim of the present study was to investigate morphological markers of chromosomal instability (CI) in relation to cytological grade of breast cancer in fine needle aspiration cytology (FNAC) specimens.
  
  
  METHODS
  Herein we selected 55 cases of invasive ductal carcinoma diagnosed on FNAC. Representative haematoxylin and eosin (H&E)-stained smears were chosen to count chromatin bridges, multipolar mitoses per smear, and micronuclei and nuclear budding per 1000 carcinoma cells. The cases were also graded by two independent observers as grade I, II and III. The CI markers were correlated with the grade of breast carcinomas.
  
  
  RESULTS
  Out of 55 carcinomas, nine were grade I, nine grade II and 37 grade III. While none of the grade I carcinomas showed chromosomal bridges, the number per smear was 0.4 (± 0.7) and 3.1 (± 2.5) for grade II and III carcinomas, respectively. No multipolar mitoses were observed in grade I or II carcinomas; the number per smear was 3.7 (±3.0) in grade III carcinomas. The mean number per 1000 malignant cells of micronuclei was 1.2 (±1.7), 3.7 (±2.1) and 12.2 (±5.1) and of nuclear buds was 2.3 (±3.2), 4.7 (±2.1) and 12.4 (±4.7) in grade I, II and III carcinomas, respectively. There was a significant increase in the mean numbers of chromatin bridges, micronuclei and nuclear buds in grade I, II and III carcinomas (anova test; P < 0.001).
  
  
  CONCLUSIONS
  This is the first study of four morphological markers of CI in FNAC smears of breast cancer. This study establishes strong correlation of these markers with other criteria for cytological grading.
authors.affiliation: Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Verma
authors.forename: P
authors.initials: P
authors.lastname: Dey
mesh_terms: D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D043171:Chromosomal Instability / Q000235:genetics; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D060787:Neoplasm Grading
keywords: breast carcinoma; chromosomal bridge; chromosomal instability; cytological grade; fine needle aspiration cytology; micronucleus