Grading systems for breast carcinoma: comparative study of cytohistological agreement - Revista Brasileira de Ginecologia e Obstetrícia
PURPOSE: to assess the concordance of cytological tumoral and nuclear grading systems on fine needle aspiration biopsies of breast carcinoma with histological specimens and compare them to identify the best results. METHODS: cytohistological agreement was evaluated in a retrospective study of 50 cases of fine needle aspiration biopsies of histologically confirmed invasive ductal carcinoma of the breast, with 5 grading systems being applied for comparative purposes.The classifications were divided according to criteria of tumoral grading (nuclear and architectural criteria – Mouriquand and Guilford systems) and nuclear criteria (Black modified by Fisher (BM), simplified Black system (SB) and Hunt system). The grading systems used for histological analysis were those of Scarff-Bloom-Richardson modified by Elston (SBR modified) for tumor evaluation and the BM systems for nuclear evaluation. RESULT: the cytological grading systems that showed best agreement were BM and SB based on nuclear criteria (anisonucleosis, size, mitosis, and chromatin). Among the cytological grading systems based on nuclear and architectural criteria (combined), Guilford’s classification showed the best agreement, possibly due to the larger number of variables used, which permitted a smaller margin of error. CONCLUSION: the methods evaluated in the present study can be considered reasonable as cytological grading systems.
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PURPOSE: to assess the concordance of cytological tumoral and nuclear grading systems on fine needle aspiration biopsies of breast carcinoma with histological specimens and compare them to identify the best results. METHODS: cytohistological agreement was evaluated in a retrospective study of 50 cases of fine needle aspiration biopsies of histologically confirmed invasive ductal carcinoma of the breast, with 5 grading systems being applied for comparative purposes.The classifications were divided according to criteria of tumoral grading (nuclear and architectural criteria - Mouriquand and Guilford systems) and nuclear criteria (Black modified by Fisher (BM), simplified Black system (SB) and Hunt system). The grading systems used for histological analysis were those of Scarff-Bloom-Richardson modified by Elston (SBR modified) for tumor evaluation and the BM systems for nuclear evaluation. RESULT: the cytological grading systems that showed best agreement were BM and SB based on nuclear criteria (anisonucleosis, size, mitosis, and chromatin). Among the cytological grading systems based on nuclear and architectural criteria (combined), Guilford's classification showed the best agreement, possibly due to the larger number of variables used, which permitted a smaller margin of error. CONCLUSION: the methods evaluated in the present study can be considered reasonable as cytological grading systems.
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