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Introduction: Micronuclei and other nuclear abnormalities are biological indicators of genotoxicity and chromosomal instabilities. Breast lesions are frequently encountered in routine clinical practice and Fine Needle Aspiration Cytology (FNAC) is used as a routine diagnostic modality. Aim: To identify the utility of micronucleus scoring in classifying and diagnosing palpable breast lesions with FNAC. Materials and Methods: The present study was a two year retrospective analysis in the Department of Pathology of Guntur Medical College and Government General Hospital, Guntur, Andhra Pradesh. Case records and FNAC smears of breast lesions in the period from March 2018 to February 2020 were retrieved from the departmental archives. Data was analysed in the month of September 2020. A total of 108 cases were included in the study. Micronucleus scoring was done on the FNAC smears independently by two institutional pathologists who were blinded to clinical data and final diagnosis and mean micronuclear scores were obtained. Statistical analysis was done using Chi-square test on Statistical Package of the Social Sciences (SPSS) software (version 14) to determine the significance of micronuclear score in differentiating benign and malignant lesions, and in grading the malignant tumours. Results: All the cases were classified into four categories: benign, atypical favouring benign, suspicious of malignancy, invasive breast carcinoma on cytology. In the present study it was found that micronucleus scoring was effective in differentiating various benign and malignant breast lesions (p-value=0.0001) and also in grading of malignant tumours (p-value=0.05). The results obtained showed that there exists a significant level of correlation with other well established standard grading systems (Pearson correlation coefficient=0.94). Conclusion: The present study revealed that micronucleus scoring is indeed a useful and reliable method for diagnosing breast lesions and can be used as an adjunct in classifying difficult and borderline cases on cytology. [ABSTRACT FROM AUTHOR]

Context: Fine needle aspiration cytology for salivary gland lesions has shown to be adequately sensitive and specific for diagnosing and treating salivary gland pathologies. The Milan System for Reporting Salivary Gland Cytopathology was developed and introduced to provide enhanced communication and improved overall care. Aims: The present study was taken up to assess the accuracy (sensitivity, specificity, positive and negative predictive values) and risk of malignancy of various diagnostic categories when the Milan system is applied and particular emphasis has been laid on cases that showed varied cytohistopathological correlation to highlight the analytical intricacies. Settings and Design: The present study is a two-year retrospective descriptive study conducted in a tertiary care hospital, Vijayawada. Methods and Material: Fine needle aspiration smears, relevant clinical details, histopathological slides and final reports were retrieved from the Departmental archives. The FNA results of the present study were re-categorized according to the Milan system and number of false positives, false negatives, true positives and true negatives were assessed in comparison with the final histopathological diagnosis and thus the accuracy and risk of malignancy of each diagnostic category were calculated. Results: The overall cytological diagnostic accuracy for differentiating malignant from benign tumors in the present study is 90%, with a sensitivity of 73.34%, specificity of 95.56%, positive and negative predictive values of 84.62% and 91.49% respectively.In the present study the highest risk of malignancy was seen in Atypia of undetermined significance (category III-100%) according to the Milan system. Conclusions: Use of The Milan System of Reporting salivary gland Cytopathology can increase the overall effectiveness and communication with clinicians and between institutions thus improving the overall patient care. [ABSTRACT FROM AUTHOR]