Please enter verification code
Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods
Science Journal of Clinical Medicine
Volume 4, Issue 4-1, July 2015, Pages: 26-30
Received: Jun. 22, 2015; Accepted: Jun. 23, 2015; Published: Aug. 3, 2015
Views 4171      Downloads 147
T. S. Rekha, Department of Pathology, JSS Medical College, Constituent College of JSS University, Mysore, India
N. M. Nandini, Department of Pathology, JSS Medical College, Constituent College of JSS University, Mysore, India
Article Tools
Follow on us
Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index (MCI) with various other cytology grading methods and histopathology. Result: Modified MCI has over all concordance rate of 86%, sensitivity of 86%, specificity of 50%, positive predictive value (PPV) of 93% and negative predictive value (NPV) of 30%. Multiple regression analysis revealed an r2 value of 60%, which was significant. The p-value of anisonucleosis, nucleoli and chromatin pattern were 0.001, 0.05 and 0.02 respectively, which was significant (p-value less than 0.05). Conclusion: Modified MCI will help the cytopathologist to accurately delineate both benign and malignant neoplastic breast lesions into respective categories. This in turn will help the treating surgeon to plan the treatment modality of the patients with lump in the breast. The study recommends that modified MCI method to be routinely incorporated for evaluation of all lump in the breast.
Breast, Masood Cytology Index, FNAC, Cytology
To cite this article
T. S. Rekha, N. M. Nandini, Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods, Science Journal of Clinical Medicine. Special Issue: Latest Different Concepts of Gynaecology. Vol. 4, No. 4-1, 2015, pp. 26-30. doi: 10.11648/j.sjcm.s.2015040401.17
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F.GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet].Lyon, France: International Agency for Research on Cancer; 2013. Available from:, accessed 17/09/2014.
Zagorianakou P, Fiacequentos, Zagorianakou N, Makrydimas G, Stefanou D, Agnantis NJ. FNAC:Its role limitations and prospective in the preoperative diagnosis of breast cancer. Eur J Gynaecol Oncol 2005;26:143-9.
Tham TM, Iyengar KR, Taib NA, Yip Ch. Fine needle aspiration biopsy, core needle biopsy or excision biopsy to diagnose breast cancer- which is the ideal method? Asian Pac J Cancer Prev 2009;10:155-8.
Fitzgibbons PL, et al. Benign breast changes and the risk for subsequent breast cancer: an update of the 1985 consensus statement. Arch Pathol Lab Med 1998;122:1053.
Schnitt SJ. Benign breast disease and breast cancer risk: morphology and beyond. Am J Surg Pathol 2003;27:836.
Hartmann LC, et al. Benign breast disease and the risk of breast cancer. N Engl J Med 2005;353:229.
Hunt CM, Ellis IO, Elston CW, et al. cytological grading of breast carcinoma – a feasible proposition? Cytopathol 1990;1:287-95.
Cajulis RS, Hessel RG, Frias-Hidvegi D, Yu GH. Cytologic grading of fine needle aspirates of breast carcinoma by private practice pathologists. Acta Cytol 1997;41:152-3.
Robinson IA, McKee G, Nicholson A, et al. Prognostic value of cytological grading of fine needle aspirates from breast carcinomas. Lancer 1994;343:947-9.
Masood S, Frykberg ER, McLellan GL, Dee S, Bullard JB. Cytologic differentiation between proliferative and nonproliferative breast disease in mammographically guided fine-needle aspirates. Diagn Cytopathol 1991;7:581-90.
Nandini NM, Rekha TS, Manjunath GV. Evaluation of scoring system in cytological diagnosis and management of breast lesion with review of literature. Indian J Cancer 2011;48;2011:240-45.
Rekha TS, Nandini NM, Murali D. Expansion of Masood’s cytologic index for breast carcinoma and its validity. J Cytol 2013;30:233-6.
Schulte E, Wittekind C. The influence of the wet-fixed Papanicolaou and the air-dried Giemsa techniques on nuclear parameters in breast cancer cytology: A cytomorphometric study. Diagn Cytopathol 1987;3:256-61.
Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. The value of histological grade in breast carcinoma. Experience from a large study with long-term follow-up. Histopathology 2002;41:152-3.
Bhatt JV, Shah JM, Shah FS. Pathophysiology of breast lesions: Vision beyond the clinical eye. J Appl Basic Med Sci 2002;4:81-4.
Ramnath T, Deenu N, Nandankumar A. Projections of number of cancer cases in India (2010-2020) by cancer groups. Asian Pacific J Cancer Prev.2010; 11:1945-9.
Nicholson S, Sainsbury JR, Wadehra V, Needham GK, Farndon JR. Use of fine needle cytology with immediate reporting in the diagnosis of breast disease. Br J Surg 1988;75:847-50.
Dehn TC, Clarke J, Dixon JM, Crucioli V, Greenall MJ, Lee EC. Fine needle aspiration cytology, with immediate reporting, in the outpatient diagnosid of breast disease. Ann R Coll Surg Engl 1987;69:280-2.
Kocjan G. Needle aspiration cytology of the breast: current perspective on the role in diagnosis and management. Acta Med Croatica, 2008;62;391-401.
Masood S. Cytomorphology of fibrocystic change, high-risk proliferative breast disease and premalignant breast lesions. Clin Lab Med 2005;25:713-31.
Haybittle JL, Blamey RW, Elston CW, Johnson J, Doyle PJ, Campbell FC, et al. A prognostic index in primary breast cancer. Br L Cancer 1982;45:361-6.
Kollias J, Elston IO, Robertson JF, Blamey RW. Early-onset breast cancer-Histopathological and prognostic considerations. Br J Cancer 1997;75:1318-23.
Ohri A, Jetly D, Shukla K, Bansal R. Cytological grading of breast neoplasia and its correlation with histological grading. Indian J Pathol Microbiol 2006;49:208-13.
Cardoso F, Costa A, Norton L, Cameron D, Cufer T, Fallowfield L, et al. 1st International consensus guidelines for advanced breast cancer (ABC 1). Breast 2012;21:242-52.
The uniform approach to breast fine needle aspiration biopsy. A synopsis. Acta Cytol. 1996;40:1120–6.
Zoppi JA, Pellicer EM, Sundblad AS. Cytohistologic correlation of nuclear grade in breast carcinoma. Acta Cytol 1997; 41:701-4.
Bhargava V, Jain M, Agarwal K, Thomas S, Singh S. Critical appraisal of cytological nuclear grading in carcinoma of the breast and its correlation with ER/PR expression. J Cytol. 2009; 25:58–61.
Dabbs DJ. Role of nuclear grading of breast carcinomas in fine needle aspiration specimens. Acta Cytol 1993;37:361-6.
Lingegowda JB, MuddeGowda PH, Ramakantha CK, Chandrasekar HR. Cytohistological correlation of grading in breast carcinoma. Diagn Cytopathol. 2011;39:251–7.
Chabra S, Singh PK, Agarwal A, Bhagoliwal A, Singh SN. Cytological grading of breast carcinoma – A multivariant regression analysis. J Cytol 2005;22:62-5.
Sood N, Nigam JS, Yadav P, Rewri S, Sharma A, Omhare A, et al. Comparative Study of Cytomorphological Robinson's Grading for Breast Carcinoma with Modified Bloom-Richardson Histopathological Grading. Patholog Res Int 2013. 2013:146542.
Das AK, Kapila K, Dinda AK, Verma K. Comparative evaluation of grading of breast carcinomas in fine needle aspirates by two methods. Indian J Med Res. 2003;118:247–50.
Phukan JP, Sinha A, Deka JP. Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading. South Asian J Cancer. 2015;4:32–4.
Saha K, Raychaudhuri G, Chattopadhyay BK, Das I. Comparative evaluation of six cytological grading systems in breast carcinoma. J Cytol. 2013;30:87–93.
Sinha S, Sinha N, Bandyopadhyay R, Mondal SK. Robinson's cytological grading on aspirates of breast carcinoma: Correlation with Bloom Richardson's histological grading. J Cytol. 2009;26:140–3.
Meena SP. Hemrajani DK, Joshi N. a comparative and evaluative study of cytological and histological grading system profile in malignant neoplasm of breast – an important prognostic factor IJPM 2005;49:73-4.
Khan N, Afroz N, Rana F, Khan MA. Role of cytologic grading in prognostication of invasive breast carcinoma. J cytol 2009;26:65-8.
Nggada HA, Tahir MB, Musa AB, Gali BM, Mayun AA, Pindiga UH, Yawe KD, Khalil MI. Correlation between histopathologic and fine needle aspiration cytology diagnosis of palpable breast lesions; a five-year review. Afr J Med Med Sci 2007; 36;295-8.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186