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  • Trabalhos Originais

    Grading systems for breast carcinoma: comparative study of cytohistological agreement

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(2):87-94

    Summary

    Trabalhos Originais

    Grading systems for breast carcinoma: comparative study of cytohistological agreement

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(2):87-94

    DOI 10.1590/S0100-72032003000200003

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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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  • Trabalhos Originais

    Immunoexpression of Her-2 protein in fine-needle aspirates of breast carcinoma: correlation with surgical specimens

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(1):23-28

    Summary

    Trabalhos Originais

    Immunoexpression of Her-2 protein in fine-needle aspirates of breast carcinoma: correlation with surgical specimens

    Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(1):23-28

    DOI 10.1590/S0100-72032003000100004

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    PURPOSE: to determine the expression of HER-2 protein in fine-needle aspirates obtained from infiltrating breast duct carcinoma and in the corresponding surgical specimens and to correlate HER-2 expression with histological grade. Methods: forty-eight smears fixed in alcohol and previously stained by the Papanicolaou technique and histological sections of corresponding paraffin-embedded tissue blocks were submitted to immunohistochemistry by the avidin-biotin-peroxidase method using a polyclonal antibody (A0485-Dako). The reactions were carried out simultaneously with antigen recovery. The results were analyzed by a semiquantitative method according to the HercepTest score. Scores of 3+ were considered to be positive. RESULTS: positivity was observed in 39.6% of the smears and in 35.4% of the respective histological sections, with almost perfect cytohistologic concordance (kappa 0.82). The method of evaluation of histological sections was found to be reproducible regarding the smears and standardized the interpretation of the results. The correlation between HER-2 positivity and histological grade was not statistically significant but there was a tendency towards HER-2 expression in less differentiated tumors. CONCLUSION: the positivity of the immunocytochemical reactions observed in smears was comparable to that obtained in the histological sections, indicating that the material obtained by fine-needle aspiration biopsies previously stained by the Papanicolaou technique can be used for the evaluation of HER-2 expression.

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