Validity of Different Cytological Grading Systems of Breast Carcinoma - a Hospital-based Study in South India

Introduction: With increase in the incidence of breast carcinoma, fine needle aspiration cytology (FNAC) has began to play a major role in diagnosing and grading. The study was aimed at validating the different cytological grading systems like Hunt’s cytological grading (HCG), modified Black grading (MBG), Robinson’s cytological grading (RCG) and Masood’s cytology index (MCI) in comparison with a modified Bloom-Richardson (MBR) histopathological grading. Methods and Material: Fifty breast carcinoma cases were prospectively studied by comparing various cytological grading methods with histopathological grading over a period of three years. All statistical analyses were carried out with the Epi-info package.
Results: The concordance rate of RCG was 82% which is highest of all, while that of MBG was 68%. HCG and MCI were not comparable with MBR due to insufficient grading.
Conclusions: RCG for breast carcinoma is validated. A consensus for a standard cytological grading method similar to the gold standard MBR histological grading must be arrived at based on conducted comparative studies and has to be inculcated in routine cytology reports.