CYTOLOGIC NUCLEAR GRADING OF FINE-NEEDLE CYTOPUNCTURES OF BREAST-CARCINOMA - COMPARISON WITH HISTOLOGIC NUCLEAR GRADING AND IMAGE CYTOMETRIC DATA

OBJECTIVE: To evaluate nuclear grading on fine needle cytopunctures of breast carcinoma, which is of special interest when neoadjuvant chemo therapy is planned. STUDY DESIGN: In a prospective study, we compared cytologic grading, based on nuclear parameters (pleomorphism and mitos is), to modified Scarff-Bloom-Richardson histologic grading in 105 pri mary operable breast carcinomas. The results of these two nuclear grad ing systems were compared to Feulgen image analysis data from the corr esponding cytologic samples. RESULTS: The concordance rate between the two grading systems was 76%. Concordance between cytologic and histol ogic grading was observed more frequently in purely invasive carcinoma s (85%) than in cases combining invasive and in situ components (56%). A highly significant relationship was observed between the two gradin g systems and indices of proliferative activity (S-phase fraction, pro liferation index, 5c exceeding rate and endoreduplication rate), parti cularly in concordant grading. Furthermore, nuclear area correlated wi th the results of the two grading systems. CONCLUSION: Cytologic nucle ar grading appeared to be a reliable tool for a large proportion of br east tumors. Despite difficulties related to tumor heterogeneity, whic h could be detected by careful cytologic examination, it is a useful a lternative to histologic grading.