Table of Contents
ISRN Oncology
Volume 2014, Article ID 252103, 6 pages
Research Article

Comparison of 3-Tier Cytological Grading Systems for Breast Carcinoma

Department of Pathology, Sree Balaji Medical College and Hospital, No. 7, CLC Works Road, Chrompet, Chennai 44, India

Received 20 January 2014; Accepted 4 March 2014; Published 12 March 2014

Academic Editors: A. E. Pinto and Z. Suo

Copyright © 2014 Dinisha Einstien et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Fine-needle aspiration cytology plays a major role in the primary diagnosis of breast carcinoma. Cytological grading of the smears can provide valuable prognostic information and aid in planning the management options. Aim. To evaluate various 3-tier cytological grading systems and to determine the best possible system which is reliable and objective for use in routine practice. Materials & Methods. 72 fine-needle aspiration smears of breast carcinomas were graded by two pathologists and compared with the histologic grading by Nottingham modification of Scarff-Bloom-Richardson method. Concordance and correlation studies were done. Kappa measurement of interobserver agreement was also done. Results. Robinson’s method showed a better correlation (77.7%) and substantial Kappa value of agreement with Bloom Richardson’s histological grading method in comparison to the other methods, closely followed by Fisher’s method. Fisher’s method showed better interobserver agreement (84.7%, ) compared to the other systems. Conclusions. Robinson’s method of cytological grading in fine-needle aspiration smears of breast carcinoma is simpler, multifactorial, and feasible, hence being preferable for routine use according to our study.