Study of Cytomorphological Patterns of Neoplastic Breast Lesions along with Robinson’s Cytological Grading of Invasive Ductal Carcinoma

  • Malashree . Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheswara University, Sattur, Dharwad, Karnataka, India
  • Gowda Kavita Umapathy Department of Pathology, S.S. Institute of Medical Sciences & Research Centre, Davangere, Karnataka, India
  • Shashikala P Department of Pathology, S.S. Institute of Medical Sciences & Research Centre, Davangere, Karnataka, India
Keywords: IAC Yokohama reporting system, Modified Bloom Richardson’s histopathological grading

Abstract

Background Fine Needle Aspiration Cytology (FNAC) plays an important role as it is a simple, minimally invasive, cost-effective, outpatient-based, and rapid diagnostic method. Grading of breast carcinoma is ideal as it helps in the selection of patients for appropriate therapy. The study was undertaken to observe the cytomorphological patterns of neoplastic lesions, assess the grade of invasive ductal carcinoma by Robinson’s cytological grading, and to correlate with Modified Bloom Richardson’s histopathological grading wherever possible. Material and Methods A descriptive cross-sectional study was conducted over a period of 2 years (July 2015-June 2017). FNAC of neoplastic breast lesions was studied. Invasive ductal carcinomas were graded according to Robinson’s cytological grading system and compared with Modified Nottingham Bloom-Richardson’s histological grading in instances where resected specimens were available. Results In the present study, fibroadenoma (31/33; 94.0%) was the most common benign neoplasm and invasive ductal carcinoma (40/41; 97.6%) was the most common malignant neoplasm. According to Robinson’s cytological grading done on IDC breast, the majority of the cases were grade II [24 (60.0%)]. Histopathological correlation was done by Modified Bloom Richardson’s grading on 13 cases of IDC in which 6 (42.8%) cases were in grade II followed by grade III and I. There was a significant concordance of 71.4% (p=0.015) between Robinson’s cytological grading system and Modified Nottingham Bloom Richardson’s histopathological grading system. Conclusion Robinson’s cytological grading on invasive ductal carcinoma of the breast has good concordance with Modified Bloom Richardson’s histopathological grading.

References

Embaye KS, Raja SM, Gebreyesus MH, Ghebrehiwet MA. Distribution of breast lesions diagnosed by cytology examination in symptomatic patients at Eritrean National Health Laboratory, Asmara, Eritrea: A retrospective study. BMC Womens Health. 2020;20(1):250.

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. Pathol Res Int. 2013;2013:1–5.

Bibbo M, Wilbur DC. Comprehensive Cytopathology. 3rd ed. Philadelphia: Saunders Elsevier; 2008. p. 713.

Sharif A, Tabassum T, Riaz M, Akram M, Munir N. Cytomorphological patterns of palpable breast lesions diagnosed on fine needle aspiration cytology in females. Eur J Inflamm. 2020;8:01-08.

Sinha SK, 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(4):140-3.

Kalhan S, Dubey S, Sharma S, Dudani S, Preeti, Dixit M. Significance of nuclear morphometry in cytological aspirates of breast masses. J Cytol. 2010;27(1):16-21.

Field AS, Raymond WA, Rickard M, Arnold L, Brachtel EF, Chaiwun B, et al. The international academy of cytology Yokohama system for reporting breast fine-needle aspiration biopsy cytopathology. Acta Cytol. 2019;63:257–73.

Robinson IA, McKee G, Nicholson A, Jackson PA, Cook MG, D'Arcy J, et al. Prognostic value of cytological grading of fine-needle aspirates from breast carcinomas. Lancet. 1994;343(8903):947-9.

Frias AR, Campora RG, Parra DM, Frias MJR, Cerezuela TV, Salaverri CO, et al. Robinson Cytologic Grading of Invasive Ductal Breast Carcinoma. Acta Cytol. 2005;49(2):149-53.

Rosai J. Rosai and Ackerman's Surgical Pathology. 9th ed. Elsevier; 2004. p. 1825.

Pinto D, Schmitt FC. Immunohistochemistry applied to breast cytological material. Pathobiology. 2022;89(5):343–58.

Singh A, Haritwal A, Murali BM. Pattern of breast lumps and diagnostic accuracy of fine needle aspiration cytology; a hospital based study from Pondicherry, India. Internet J Pathol. 2011;11(2):1-6.

Vasudev V. The cytological grading of malignant neoplasms of the breast and its correlation with the histological grading. J Clin Diagn Res. 2013;7(7):1403-8.

Bukya VP, Nandyala R, Banoth M, Yootla M, Chowhan AK, Prayaga AK. Comparative study of Robinson’s and Mouriquand’s cytological grading systems and correlation with histological grading in breast carcinoma. J Clin Diagn Res. 2018;12(7):4-8.

Khan A, Jamali R, Jan M, Tasneem M. Correlation of fine needle aspiration cytology and histopathology diagnosis in the evaluation of breast lumps. Int J Med Stud. 2014;2(2):40-3.

Singh P, Chaudhary M, Nahuria S, Rao D. Cytomorphological patterns of breast lesions diagnosed on fine-needle aspiration cytology in a tertiary care hospital. Int J Med Sci Public Health. 2015;4(5):674-9.

Kuijper A, Mommers EC, van der Wall E, van Diest PJ. Histopathology of fibroadenoma of the breast. Am J Clin Pathol. 2001;115(5):736-42.

Gupta D, Bhutani N, Mukherjee M. Cytological profile of various breast lesions with special reference to breast carcinoma and its correlation with ER & PR status: a prospective analysis of 192 cases. Eur J Pharm Med Res. 2016;4(1):333-7.

Bafakeer SS, Banafa NS, Aram FO. Breast diseases in Southern Yemen. Saudi Med J. 2010;31(9):1011-4.

Vijaykumar A, Ajitha MB, Shivaswamy BS, Srinivasan N. A systematic study on fibroadenoma of the breast. Eur J Surg Sci. 2012;3(3):80-5.

Ayata G, Abu-Jawdeh GM, Fraser JL, Garcia LW, Upton MP, Wang HH. Accuracy and consistency in application of a probabilistic approach to reporting breast fine needle aspiration. Acta Cytol. 2003;47(6):973-8.

Özkara SK, Üstün MÖ, Paksoy N. The Gray Zone in Breast Fine Needle Aspiration Cytology. Acta Cytol. 2002;46(3):513-8.

Saikia B, Choudhury D, Sharma I. Fine Needle Aspiration Cytology of Fibroadenoma of Breast in a Tertiary Level Hospital. Indian J Sci Stud. 2017;5(3):24-8.

Yusuf I, Atanda AT. Validity of fine needle aspiration cytology of the palpable breast lesions: a teaching hospital experience. Niger J Basic Clin Sci. 2014;11(1):36-40.

Yeoh GP, Chan KW. Fine needle aspiration of breast masses: an analysis of 1533 cases in private practice. Hong Kong Med J. 1998;4:283-8.

Kujur P. Fine Needle Aspiration of the Palpable Breast Lump of 106 Cases and Correlation with Histologic Diagnosis: A Prospective Analysis. Indian J Sci Stud. 2015;3(9):111-5.

Thakkar B, Parekh M, Trivedi NJ, Agnihotri AS, Mangar U. Role of Fine needle aspiration cytology in palpable breast lesions and its correlation with histopathological diagnosis. Natl J Med Res. 2014;4:283-8.

Shrestha A, Chalise S, Karki S, Shakya G. Fine needle aspiration cytology in a palpable breast lesion. J Pathol Nepal. 2011;1(2):131-5.

Yusufu LM, Odigie VI, Mohammed A. Breast masses in Zaria, Nigeria. Ann Afr Med. 2003;2(1):13-6.

Likhar KS, Fatima A, Hazari RA, Gupta SG, Shukla U. Diagnostic role of FNAC in breast lesions. Int J Res Rev Med Sci. 2013;3(1):12-4.

Sankaye SB, Dongre SD. Cytological study of palpable breast lumps presenting in an Indian rural setup. Indian J Med Paediatr Oncol. 2014;35(2):159-64.

Pandya AN, Shah NP. Comparative evaluation of Robinson’s cytological grading with Elston and Ellis’ Nottingham modification of Bloom Richardson histopathology grading for breast carcinoma. Natl J Community Med. 2012;3(3):491-5.

Ravikumar G, Rout P. Comparison of cytological versus histopathological grading of invasive ductal carcinoma of the breast with correlation of lymph node status. Middle East J Cancer. 2015;6(2):91-6.

Rubina Younis IM, Zubair A, Azam S, Saadia A. Cytological grading of breast cancer according to Robinson’s grading system. Pak Armed Forces Med J. 2016;66(4):490-3.

Rajendran K, Sudalaimuthu M, Ganapathy S. Cytological grading of breast carcinomas and its prognostic implications. Cureus. 2022;14(9):2-10.

Kundu R, Handa U, Kumar A, Dalal U, Mohan H. Evaluation of grading and hormone receptor immunostaining on fine needle aspirates in carcinoma breast. J Cytol. 2015;32(1):1.

Pal S, Gupta M. Correlation between cytological and histological grading of breast cancer and its role in Prognosis. J Cytol. 2016;33(4):182.

Chokshi M, Mehta N. Cytological study of palpable breast lumps (407 cases) with their histological correlation. Int J Med Sci Public Health. 2014;3(2):181-5.

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.

Rekha TS, Nandini NM, Dhar M. Validity of different cytological grading systems of breast carcinoma-a hospital-based study in South India. Asian Pac J Cancer Prev. 2011;12(11):3013-6.

Published
26-05-2024
Section
Original Article