Cytological Grading of Duct Cell Carcinoma. NOS of Breast and its Correlation with Histological Grading

Fine needle aspiration cytology is a widely practiced technique in the diagnosis of breast carcinoma and it is the only, diagnostic procedure performed before definitive treatment, at most institutions. While the histol ogical grading of Duct Cell Carcinoma (DCC), NOS is done routinely in many centers worldwide the cytopathological grading of DCC, NOS is not commonly done. Grading of breast carcinoma, while the tumour is still in vivo, would be th e most ide al and desirable situation, as it would be helpful in the selection of appropriate therapy for th e patient. This study was undertaken with the aim to determine the grade of DCC, NOS by simple cytological scoring system as a method of predicting histological gr ade. We selected 80 cases of DCC, NOS which were initially diagnosed by Fine Needle Aspiration Cytology (FNAC) with subsequent histological confirmation. For cytological grading Papanicolou s stained smears and for histological grading Haematoxylin and Eosin stained sections were examined under light microscope. For histol ogical gr ading Scraff Bloom Richardson s grading and for cytological grading Robinson s grading were followed. In both system grading were grade I, grade II and gr ade III of DCC, NOS. On cytological grading 39(48.8 %) cas es were grade-I, 38(47.5 %) cases were grade-If and 3(3.8%) cases were grade-III. On histol ogical gr ading 33(41.3 %) cases were grade-I, 39(48.8 %) cases were grade-If and 8(10 %) cases were gr ade-III. In this study cytological grade correlated with histological gr ade in 69(86.3 %) cases. For grade-I tumour, sensitivity was 96.96%, efficiency was 94%. For grade-II tumour the sensit ivity was 87.18% and efficiency was 77 %. For grade-III tumour the sensitivity was 37.50% and efficiency was 23 %. The overall accuracy was 96.3 %. Significant a ssociation between histological and cytological grading of breast carcinoma, NOS was noted. Our observations in thi s study revealed that grading of duct cell carcinoma, NOS on FNAC material can be a useful in preoperative assessment ofDCC, NOS prognosis and can be useful as an alternative to histological grading when neoadjuvant therapy is planned.