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Background The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades. Methods This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study. Results A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson’s system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall’s tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001). Conclusions A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor’s aggressiveness and predict its histological grade.

Background: Diagnosis of breast cancer is made in most of the cases near accurately by fine needle aspiration cytology. With the advent of neoadjuvant chemotherapy, the need for identification of aggressiveness of the tumor has become essential. So cytological grading may be of prime importance for the patient, who may undergo neoadjuvant therapy prior to surgical resection. Objective of this study was to grade the breast carcinoma on FNAC using Robinson’s and Mouriquand’s grading systems and to assess the concordance of both cytological grading systems with histological grading using a modified Scarff-Bloom-Richardson grading system. Materials and Methods: This study was done between 2016 and 2018 in subjects with breast carcinoma undergoing FNAC. Cytological grading of the samples was done by Robinson’s and Mouriquand’s methods. Subsequent Histological grading was done on subsequent specimens according to the Modified Bloom Richardson grading system. Obtained histological grades were correlated with the cytological grades. Results: Robinson’s grading system showed a significant association with the Modified Bloom Richardson grading system (p

Background: The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades., Methods: This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study., Results: A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson's system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall's tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001)., Conclusions: A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor's aggressiveness and predict its histological grade.

Introduction: Breast lesions are the leading cause of morbidity and mortality in women. Fine needle aspiration cytology (FNAC) of Breast is a significant component of the "Triple approach" for pre-operative diagnosis of breast lumps. This study is undertaken to explore the utility and accuracy of FNAC in various breast pathologies. Aim: This study aims to classify various breast lesions according to the International Academy of Cytology (IAC) grading system and grade breast carcinoma on FNAC using Robinson's grading system which is then correlated with histopathology and also to evaluate the diagnostic accuracy, sensitivity, and specificity of FNAC in diagnosing breast lesions. Materials and methods: The study was conducted on patients with breast lump. This study was conducted by retrieving FNAC smears and were grouped under five standardized categories proposed by the IAC: Category I (Insufficient material), Category II (Benign), Category III (Atypical), Category IV (Suspicious) & Category V (Malignant) respectively. C5 cases were graded by Robinson's grading system which was then compared with the histopathological Elston Ellis modified Bloom-Richardson grading system. Results: Category I, II, III, IV, and V accounted for 10 (12.5%), 43 (53.75%), 3 (3.75%), 5 (6.25%), and 19 (23.75%) of the 80 breast lesions reported on FNAC, respectively. Histopathology correlations were available in 59 cases. The sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were 80%, 100%, 100%, 92.10%, and 94% respectively. Conclusion: Cytological characterization based on IAC structured reporting will enhance diagnostic clarity and comparison with histopathology establishes the diagnostic accuracy of FNAC. [ABSTRACT FROM AUTHOR]

Background: Invasive ductal carcinoma is one of the most common type of tumors in females, constituting a single large group of breast cancers. There are various prognostic factors, of which tumor grade, size and axillary lymph node metastasis are among the important ones. Fine needle aspiration cytology is a commonly used diagnostic technique in the initial evaluation of breast lumps. In the era of neoadjuvant chemotherapy, the material obtained from fine needle aspiration cytology is often the only baseline morphology available for future evaluation. Therefore the assessment of cytological grade in fine needle aspiration cytology samples is useful. In addition, correlating cytological grade with axillary lymph node status is indicative of tumor aggressiveness. This study correlates the cytological grade with histological grade and axillary lymph node status. Methods: Patients with cytological diagnosis of ductal carcinoma who underwent subsequent resection and axillary clearance over a period of five years were included in the study. Fine needle aspiration cytology smears were graded by Robinson’s method and compared with the Modified Bloom Richardson’s histopathological grading and axillary lymph node metastasis. Results: There were a total of 98 cases of invasive ductal carcinoma. Patients’ ages ranged from 28 to 98 years with a mean of 52.17 years. In terms of cytology, there were 22 (22.4%) grade I cases, 61(62.2%) grade II, and 15 (15.3%) grade III. For histopathology, 22 (22.4%) were grade I, 56 (57.1%) were grade II, and 20 (20.4%) were grade III. In 76 (77.5%) cases the cytological grade correlated with histological grade, but did not show any significant positive correlation with axillary lymph node metastasis. Conclusion: Cytological grade can be used as a predictor of histological grade, but may not predict axillary lymph node metastasis in patients with invasive ductal carcinomas.

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.

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 (p = 0.801; P = 0.0001 andx = 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. [ABSTRACT FROM AUTHOR]

Introduction: The early diagnosis of breast carcinoma is of paramount importance in its management. Fine-needle aspiration cytology (FNAC) has the potential to play a pivotal role in providing the relevant information on the aggressiveness of this tumor. But there is no gold standard when it comes to cytological grading of breast carcinoma as there is no consensus between the pathologists and also the clinicians as to which grading is as par with the gold standard Elston-Ellis modification of Scarff-Bloom-Richardson (SBR) histological grading. This study was undertaken to study seven cytological 3-tier grading systems, namely, Robinson's, Fisher's, Mouriquand's, Dabbs', Khan's, Taniguchi's, and Howells's and to correlate them with the Elston-Ellis modification of SBR histological grading system so as to determine the finest cytological grading system which could be reliably used in our routine practice., Material and Methods: A total of 117 breast carcinoma cases diagnosed on FNAC were graded using seven 3-tier cytological grading systems and were correlated with Elston-Ellis modification of SBR histological grading system. Concordance, kappa measurement, and various correlation studies were done using SPSS software version 2021., Results: Robinson's method showed a better concordance (84.61%), a better correlation (Spearman = 0.750, τ = 0.731, p < 0.001), and a substantial kappa value of agreement (κ = 0.701) with SBR grading system compared to other system closely followed by Fisher's system., Conclusions: Even though all the seven 3-tier cytological grading systems positively correlated with the SBR histologic grading of breast carcinoma, Robinson's method showed better concordance and correlation with a substantial kappa value of agreement in comparison to other 3-tier cytology grading systems. Hence, Robinson's grading which is simpler and also feasible should be incorporated in the routine cytology reporting of breast carcinoma., (© 2023 S. Karger AG, Basel.)

Background: Invasive ductal carcinoma is one of the most common type of tumors in females, constituting a single large group of breast cancers. There are various prognostic factors, of which tumor grade, size and axillary lymph node metastasis are among the important ones. Fine needle aspiration cytology is a commonly used diagnostic technique in the initial evaluation of breast lumps. In the era of neoadjuvant chemotherapy, the material obtained from fine needle aspiration cytology is often the only baseline morphology available for future evaluation. Therefore the assessment of cytological grade in fine needle aspiration cytology samples is useful. In addition, correlating cytological grade with axillary lymph node status is indicative of tumor aggressiveness. This study correlates the cytological grade with histological grade and axillary lymph node status. Methods: Patients with cytological diagnosis of ductal carcinoma who underwent subsequent resection and axillary clearance over a period of five years were included in the study. Fine needle aspiration cytology smears were graded by Robinson's method and compared with the Modified Bloom Richardson's histopathological grading and axillary lymph node metastasis. Results: There were a total of 98 cases of invasive ductal carcinoma. Patients' ages ranged from 28 to 98 years with a mean of 52.17 years. In terms of cytology, there were 22 (22.4%) grade I cases, 61(62.2%) grade II, and 15 (15.3%) grade III. For histopathology, 22 (22.4%) were grade I, 56 (57.1%) were grade II, and 20 (20.4%) were grade III. In 76 (77.5%) cases the cytological grade correlated with histological grade, but did not show any significant positive correlation with axillary lymph node metastasis. Conclusion: Cytological grade can be used as a predictor of histological grade, but may not predict axillary lymph node metastasis in patients with invasive ductal carcinomas. [ABSTRACT FROM AUTHOR]