Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation

Abstract

Introduction: Fine needle aspiration cytology (FNAC) is a rapid and inexpensive technique for the diagnosis of breast lesions. Various cytological grading systems are being used for categorisation. For better advancement of categorization and management of breast lesions Modified Masood scoring system has been proposed. Objective: To study the effectiveness and accuracy of Modified Masood Scoring Index (MMSI) and Robinson’s cytological grading for evaluation of breast lesions with their histopathological correlation. Methods: A prospective study was conducted in a tertiary care hospital from September 2019 to February 2020. A total of 73 cases were included in the study which had undergone FNAC and had histopathological samples as excision biopsy and mastectomy. The cytological smears were categorised by using MMSI, Robinson’s cytological grading system and were compared with the histological findings (the four categories of MMSI) and for carcinoma, cases modified Scarff–Bloom–Richardson’s scoring system was used. Results: The sensitivity, specificity, Positive predictive value (PPV), Negative predictive value (NPV) and diagnostic accuracy of MMSI were 76.4%, 100%, 100%, 93.3% and 94.5% respectively. The Robinson’s grading had sensitivity, specificity, PPV, NPV and diagnostic accuracy of 88.2%, 100%, 100%, 96.5% and 97.2% respectively. Conclusion: Robinson’s cytological grading had good sensitivity for evaluation of malignant lesions whereas MMSI can be used for the categorization of both benign and malignant breast lesions with good sensitivity.