Comparative Evaluation of Three Cytological Grading Systems for Carcinoma Breast

Background: Fine needle aspiration cytology is an important tool in the diagnosis, prognosis and management of breast carcinoma. It has been recommended that cytological grading should be included in the FNA reports to know the tumor aggressiveness and prognostication. Among the many cytological grading systems existing, there is still no agreement on the most reliable system. Aim: The study was undertaken to evaluate three cytological grading systems and correlate with histological grading by Nottingham modification of Scarff Bloom Richardson (SBR) method. Materials and Methods: Cytological grading by Robinson’s grading, Fisher’s modification of Black nuclear grading and Howell grading systems was done on 50 carcinoma breast cases. Histological grading by Nottingham modification of SBR grading was done. Cytohistologic grading correlation was done by testing concordance, association and correlation. Results: The three cytological grading systems correlated well with histological grading. Fisher’s modification of Black nuclear grading system demonstrated the best correlation ( = 0.61; P < 0.001) and concordance (Percent of agreement=70%) with the SBR’s grading system.Conclusions: Fisher’s modification of Black nuclear grading system is simple, reproducible and showed the best concordance with histological grading.