Correlation between cytological and histological grading of breast cancer and its role in prognosis

CONTEXT: Assigning grade to breast cancer on FNAC provides prognostic information and guides optimal therapy. AIMS: The present study was undertaken to grade breast carcinoma on cytology by Robinson's grading system and correlate it with Elstons modified Bloom Richardson histological grading system. SETTINGS AND DESIGN: It is a prospective study done on fifty cases of breast cancer reported on cytology. MATERIALS AND METHODS: Fifty patients who underwent FNAC and mastectomy for breast carcinoma were cytologically and histologically graded. Correlation between cytological and histological grading system was determined. Sensitivity and specificity of Robinson's cytological grading system was calculated in each grade. All cases evaluated for presence of metastasis to axillary lymph nodes. STATISTICAL ANALYSIS USED: Correlation between cytological and histological grading was established using the non parametric Spearmanâ€(™) s correlation coefficient. RESULTS: Concordance rate between cytological and histological grade was 78%. The coefficient of correlation between cytological grade and histological grade was 0.804 and P value was <0.001 which indicated a strong correlation and significant association between the cytological and histological grade. Sensitivity was maximum in cytological grade I tumors (100%) and least in cytological grade III tumors (45.45%). Specificity was maximum in cytological grade III tumors (94.87%) and least in cytological grade II tumors (72.72%). The incidence of axillary lymph node metastasis was maximum in cytological grade III tumors and grade I tumors. CONCLUSIONS: Cytological grade strongly predicts histological grade and is useful in selecting neoadjuvant chemotherapy.