Robinson’s cytomorphological grading for breast carcinoma and its correlation with modified Bloom-Richardson histopathological grading

Background: Rising incidence of breast cancer in India necessitates a deeper understanding of biological behaviour of tumor. Tumor grade has a pivotal role in understanding the same. Breast cytology provides a quick diagnosis and remains vital in resource limited settings. Although cytological grading systems have been in development for some time but lack sufficient evidence to validate its correlation with histopathological grading. Methods: A prospective study over a period of 1 year, included 60 cases of invasive breast carcinoma, diagnosed on cytology (FNAC) with subsequent available histopathological examination. Robinson cytologic grading and Bloom Richardson Histologic grading was performed and correlation studied. Cytological grade was also correlated with regional node metastasis. Correlation between the two grading systems was studied using Spearman’s correlation coefficient. Association between Cytological grade and axillary lymph node metastasis was analysed by Pearson’s chi square test. Results: All 60 cases were histotyped as invasive breast carcinoma, NST. Using Robinson’s cytological grading, 38 cases (63.33%) were assigned grade II while 37 (61.67%) cases were graded as grade II histologically. Robinson’s grading system showed an absolute concordance of 85.00% with histological grading system (p<0.001). Conclusions: Cytological nuclear grade correlates precisely with the histological grade assigned to the tissue with high concordance.