title: Comparison of 3-tier cytological grading systems for breast carcinoma.
abstract: Background. Fine-needle aspiration cytology plays a major role in the primary diagnosis of breast carcinoma. Cytological grading of the smears can provide valuable prognostic information and aid in planning the management options. Aim. To evaluate various 3-tier cytological grading systems and to determine the best possible system which is reliable and objective for use in routine practice. Materials & Methods. 72 fine-needle aspiration smears of breast carcinomas were graded by two pathologists and compared with the histologic grading by Nottingham modification of Scarff-Bloom-Richardson method. Concordance and correlation studies were done. Kappa measurement of interobserver agreement was also done. Results. Robinson's method showed a better correlation (77.7%) and substantial Kappa value of agreement (κ = 0.61) with Bloom Richardson's histological grading method in comparison to the other methods, closely followed by Fisher's method. Fisher's method showed better interobserver agreement (84.7%, κ = 0.616) compared to the other systems. Conclusions. Robinson's method of cytological grading in fine-needle aspiration smears of breast carcinoma is simpler, multifactorial, and feasible, hence being preferable for routine use according to our study.
authors.affiliation: Department of Pathology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chrompet, Chennai 44, India.
authors.forename: Dinisha
authors.initials: D
authors.lastname: Einstien
authors.affiliation: Department of Pathology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chrompet, Chennai 44, India.
authors.forename: B O Parijatham
authors.initials: BO
authors.lastname: Omprakash
authors.affiliation: Department of Pathology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chrompet, Chennai 44, India.
authors.forename: Hemalatha
authors.initials: H
authors.lastname: Ganapathy
authors.affiliation: Department of Pathology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chrompet, Chennai 44, India.
authors.forename: Sadaf
authors.initials: S
authors.lastname: Rahman