SIMPLIFIED NUCLEAR GRADING OF FINE-NEEDLE ASPIRATES OF BREAST-CARCINOMA - CONCORDANCE WITH CORRESPONDING HISTOLOGIC NUCLEAR GRADING AND FLOW CYTOMETRIC DATA
Rs. Cajulis et al., SIMPLIFIED NUCLEAR GRADING OF FINE-NEEDLE ASPIRATES OF BREAST-CARCINOMA - CONCORDANCE WITH CORRESPONDING HISTOLOGIC NUCLEAR GRADING AND FLOW CYTOMETRIC DATA, Diagnostic cytopathology, 11(2), 1994, pp. 124-130
Although histologic grading of breast carcinoma is widely practiced by
most pathologists, cytologic grading of fine-needle aspirates (FNA) o
f this neoplasm is not commonly done. This study addresses the issue o
f the accuracy of a new classification system, a simplified Nuclear Gr
ading (NG) system based on the criteria proposed by Black et al. (Surg
Gynecol Obstet 1955;100;543) in FNA of breast carcinoma. We reviewed
100 cases of breast carcinoma, initially diagnosed by fine-needle aspi
ration biopsy (FNAB) with subsequent histologic confirmation, consisti
ng of 94 ductal, five lobular, and one medullary carcinoma. NG of Papa
nicolaou's stained materials were reviewed twice independently by two
pathologists and then were compared to the original histologic NG. The
concordance rate with histology ranged from 80-90%. Intraobserver rep
roducibility was 86 and 88%, while interobserver reproducibility range
d from 84-88%. Of the 88 cases with corresponding flow cytometic (FCM)
data, there were 35 diploid and 53 aneuploid cases. Fifty-nine (95%)
of histologic high NG were aneuploid or diploid with high S-phase frac
tion (SPF), while 20 (77%) of histologic low NG were diploid with low
SPF. This study confirms that nuclear grading of FNA of breast carcino
ma using a simplified NG system has a high concordance with histology,
has high intraobserver and interobserver reproducibility, and that th
is grading system correlates well with FCM analysis when tumors are si
mply divided based on NG as high or low grade. (C) 1994 Wiley-Liss, In
c.