title: Evaluation of grading and hormone receptor immunostaining on fine needle aspirates in carcinoma breast.
abstract: BACKGROUND
  Grading and hormone receptor determination in breast carcinoma are predictive factors for response to hormonal therapy.
  
  
  OBJECTIVE
  This study was undertaken to grade breast carcinoma and to determine estrogen receptor (ER) and progesterone receptor (PR) expression on fine-needle aspiration cytology (FNAC). Furthermore, the objective was to compare the results with histological grading and immunohistochemistry on surgical material.
  
  
  METHODS
  Fifty cases of breast carcinoma diagnosed on FNAC were included. The cytological grading was done according to the Robinson's grading system. The corresponding histology sections were graded using the modified Bloom-Richardson system. Immunostaining for ER and PR was done on smears and tissue sections.
  
  
  RESULTS
  On both cytological and histological evaluation, 49 cases were infiltrating ductal carcinoma and one case was colloid carcinoma. On comparing cytological and histological grading, 78% were correctly graded on cytology. The sensitivity, specificity, positive predictive value and negative predictive value for ER detection on immunocytochemistry (ICC) were 55.6%, 95%, 93.8% and 61.3%, respectively. The sensitivity, specificity, positive and negative predictive value for PR detection on ICC were 57.7%, 95.2%, 93.8% and 64.5%, respectively. The correlation for ER and PR between cytology and histology was 72.3% and 74.5%.
  
  
  CONCLUSIONS
  The grading along with ER and PR immunostaining of breast carcinoma on smears is advocated because of high concordance between cytology and histology. This allows the patient to be treated with hormonal therapy on the basis of FNAC alone.
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Handa
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Reetu
authors.initials: R
authors.lastname: Kundu
authors.affiliation: Department of General Surgery, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Dalal
authors.affiliation: Department of Pathology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Harsh
authors.initials: H
authors.lastname: Mohan
keywords: Breast carcinoma; fine needle aspiration; grading; immunostaining