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BACKGROUND Breast carcinoma is one of the most common cancer of women. Fine-Needle Aspiration Cytology (FNAC) is widely used, most convenient, quick and common preoperative diagnostic modality in breast lesions. Cytological grading on aspirates of breast carcinoma is a very useful tool for surgical manoeuvre and prognosis. The aim of the study is to study the correlation of cytomorphological Robinson’s grading with modified Bloom-Richardson’s histopathological grading of breast carcinoma. MATERIALS AND METHODS In the present study, 140 cytologically malignant breast tumour cases were included in the study and out of which, 90 cases correlated with histology after mastectomy. FNA was performed with 22-24 gauze needle and smears were stained with Haematoxylin and Eosin, Papanicolaou and May-Grunwald-Giemsa and evaluated for cytological grading according to Robinson’s grading system. H and E stained histosections were graded according to Bloom-Richardson’s grading system and comparison were done between the two. RESULTS Robinson’s cytological grading correlated well with Bloom-Richardson’s histopathological grading. The concordance rate between cytology and histology of Grade I, Grade II and Grade III tumours were 84.61%, 79.16% and 87.5%, respectively. Overall, concordance was found to be 83.6%. The Kappa value showed 95% confidence level. Thus, the strength of agreement between two grading systems considered to be fair. The P value on chi-square analysis showed

Background: The diagnosis of breast carcinoma can be reliably made by fine needle aspiration cytology (FNAC). Grading usually done in histological samples for the selection of therapy but not in cytology. Various cytological grading systems have been proposed; however, none of them is presently considered the gold standard to predict the prognosis. Aim: This study was undertaken to evaluate various 3-tier cytological grading systems and to determine the best possible system corresponds to the histological grading proposed by Elston and Ellis based on the method by Nottingham modification of Scarff-Bloom-Richardson (SBR) method. Materials and Methods: In this retrospective study, 94 cases of breast carcinoma FNACs were graded using six cytological grading systems and compared with SBR method. Concordance, association, and correlation studies were done to select best possible cytological grading system. The interobserver reproducibility among the six grading systems was also assessed. Results: Robinson method showed best correlation (r = 0.801; P = 0.0001 and t = 0.783; P = 0.0001), maximum percent agreement (83/94 cases; 88.3%), and a substantial kappa value of agreement (k = 0.737) with the Nottingham modification of SBR grading system followed by Mouriguand method. Taniguchi system showed better interobserver agreement (87.2%; k= 0.738). Conclusions: This study showed that all six cytological grading systems correlated positively with SBR method. However, Robinson's grading system demonstrated the best concordance, correlation, and substantial Kappa value of the agreement with the histological grading by SBR method in comparison to other 3-tier cytological grading systems. Hence, in conclusion, this grading should be routinely incorporated in the cytology reports as it correlates well with histological grade. Despite various cytological grading systems, Robinson's method is simple, more objective, and reproducible, hence being preferable for routine use.

Background : Cytological grading (CG) on aspirates of breast carcinoma is a useful tool for surgical maneuver and prognosis. Aims : An endeavor was made to use CG on aspirates of breast carcinoma using Robinson's grade and to correlate it with Bloom Richardsons' histopathological grading. Materials and Methods : A total of 59 patients of breast carcinoma, aged 28-57 years, were aspirated and the smears were graded using Robinson's criteria. All the cases were correlated with Bloom Richardson's grade on histopathology in mastectomy specimens. Lymphadenopathy in 38 cases was aspirated and stained with Papanicolaou and Romanowsky stain. Results : Robinson's CG correlated well with Bloom Richardson's histopathological grading. For grade I and II tumors, there was substantial strength of agreement between cytology and histopathology, while in grade III, the concordance was nearly perfect. Lymph node metastasis was found in 27 of 32 axillary nodes, three of five cervical nodes and the only palpable supraclavicular node. Lymph node metastasis was observed in three with cytological grade II, 28 of grade III and none of grade I. All grade I had stage A, two of grade II had stage B, while all grade III had either stage B or stage C disease. Conclusions : Thus, CG of breast carcinoma correlates well with histopathological grading and may well be useful as a prognostic marker.