Role of Nuclear Morphometry in Breast Cancer and its Correlation with Cytomorphological Grading of Breast Cancer: A Study of 64 Cases

BACKGROUND: Fine needle aspiration cytology (FNAC) is a simple, rapid, inexpensive, and reliable method of diagnosis of breast mass. Cytoprognostic grading in breast cancers is important to identify high-grade tumors. Computer-assisted image morphometric analysis has been developed to quantitate as well as standardize various grading systems. AIMS: To apply nuclear morphometry on cytological aspirates of breast cancer and evaluate its correlation with cytomorphological grading with derivation of suitable cutoff values between various grades. SETTINGS AND DESIGNS: Descriptive cross-sectional hospital-based study. MATERIALS AND METHODS: This study included 64 breast cancer cases (29 of grade 1, 22 of grade 2, and 13 of grade 3). Image analysis was performed on Papanicolaou stained FNAC slides by NIS –Elements Advanced Research software (Ver 4.00). Nuclear morphometric parameters analyzed included 5 nuclear size, 2 shape, 4 texture, and 2 density parameters. RESULTS: Nuclear size parameters showed an increase in values with increasing cytological grades of carcinoma. Nuclear shape parameters were not found to be significantly different between the three grades. Among nuclear texture parameters, sum intensity, and sum brightness were found to be different between the three grades. CONCLUSION: Nuclear morphometry can be applied to augment the cytology grading of breast cancer and thus help in classifying patients into low and high-risk groups.