title: Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading.
abstract: BACKGROUND
  Grading of breast carcinoma on fine needle aspiration cytology (FNAC) is beneficial for selecting patients for neoadjuvant chemotherapy.
  
  
  OBJECTIVE
  To grade the breast carcinoma on FNAC using Robinson grading system and to assess the concordance of cytological grading (CG) with histological grading (HG) using Elston-Ellis modification of Scarff-Bloom-Richardson grading system.
  
  
  METHODS
  The study was conducted for 1-year, comprising of 50 female patients attending outpatient departments (OPD) as well as admitted in various surgical wards of a teaching hospital, diagnosed as breast carcinoma. FNAC smears were stained with May-Grunwald-Giemsa and Papanicolaou (Pap) stains and CG was done using Robinson system on Pap stained smears. The results were compared with HG system after resection of tumors.
  
  
  RESULTS
  Of 50 cases, 14 (28%) cases were graded as grade I, 24 (48%) grade II, and 12 (24%) grade III by CG, whereas 9 (18%), 28 (56%) and 13 (26%) cases were graded as grade I, II and III by HG. The result showed overall 72% concordance of CG with HG, with grade II and grade III showing highest degree of concordance (83.33%), which is comparable to previous studies. Kappa measurement showed a higher degree of agreement in high-grade tumors compared with low-grade tumors (0.73 in grade III, 0.53 in grade II and 0.39 in grade I).
  
  
  CONCLUSIONS
  Cytological grading is comparable to HG in majority of cases. Because neoadjuvant chemotherapy is becoming increasingly popular as primary treatment modality of breast cancer, CG could be a useful parameter in selecting the mode of therapy and predicting tumor behavior.
authors.affiliation: Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India.
authors.forename: Jyoti Prakash
authors.initials: JP
authors.lastname: Phukan
authors.affiliation: Department of Pathology, Bankura Sammilani Medical College, Bankura, West Bengal, India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Sinha
authors.affiliation: Department of Pathology, Tezpur Medical College, Tezpur, Assam, India.
authors.forename: Jatindra Prasad
authors.initials: JP
authors.lastname: Deka
keywords: Breast carcinoma; Robinson grading; Scarff-Bloom-Richardson's grading; fine needle aspiration cytology
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