Background & Objectives: Carcinoma of the breast is the commonest cancer in urban Indian women and the second commonest cancer in the rural women next to cervical carcinoma. Neo-adjuvant therapy including pre-operative chemotherapy and tamoxifen is becoming increasingly common for early breast cancer. Hence, it is desirable to grade tumors before surgery, so that, the most appropriate medical regimen can be selected. Hence, much attention is focussed on grading tumors on FNAC. This cytologic grade also corresponds well with the histologic grade. This study was done to correlate Robinson’s cytological grading with modified Scarff Bloom Richardson’s histological grading in cases of infiltrating ductal carcinoma breast.

Material and Methods: Total 50 breast carcinoma cases were studied.  FNAC smears were graded according to Robinson’s cytological grading system while the corresponding paraffin embedded histology sections were graded as per Modified Scarff  Bloom Richardson’s grading.

Results: Out of the total 50 cases, majority belonged to 40-50 years age group with the mean age as 50.22 years. On cytological grading 19(38%), 27(54%) and 4(8%) cases were of grade I, II and III respectively while on histological grading 17(34%), 28(56%) and 5(10%) cases were of grade I, II and III respectively. The concordance rates between cytological and histological grading for grade I,II and III were 73.7%, 81.5% and 50% respectively. There was a significant association (76%) between the cytological and histological grading (p=0).

Conclusion: Besides  having minimal subjective discomfort, insignificant complications, negligible risk of tumor spread, rapidity of diagnosis, utility for multiple lesions, readily repeatability, high accuracy of FNAC; FNAC grading is comparable with histology grading and is useful in assessing the tumor behaviour and prognosis and guiding neo adjuvant chemotherapy. Hence, the cytological typing and grading should be incorporated in the FNAC report and this can be of great value in guiding the choice of the treatment protocols.

Keywords: Breast carcinoma, Robinson’s cytological grading, modified Scarff Bloom Richardson’s histological grading, FNAC.

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Dr Lalit Mohan Patel

Department of Radiotherapy, SSMC, Rewa, India

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