Evaluation of Cytological Scoring and Comparison with Histopathological Finding in a Palpable Breast Lump

Abstract

Introduction: Breast cancer is the commonest malignancy worldwide in women. Preoperative evaluation of breast lump plays a major role in the early diagnosis and management of the breast lesions. This study helps in subgrouping the breast lesions into various categories and provides the line of management of each category accordingly. Aim: To evaluate the cytomorphology of various breast lesions, to compare with histopathological findings and to assess the usefulness of Modified Masood’s Scoring Index (MMSI) in palpable breast lumps. Materials and Methods: This was a cross-sectional study done in 61 female patients presented with palpable breast lump between March 2019 and February 2021 at Pathology Department, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India. Cytological examination along with MMSI was applied on Fine Needle Aspiration Cytology (FNAC) aspirates, followed by histological confirmation. Under MMSI, the breast lesions were categorised into four groups: Non Proliferative Breast Disease (Non PBD), PBD without atypia, PBD with atypia and carcinoma breast. The data were collected and complied in Microsoft excel programme, appropriate graphs were made and percentages were calculated. Results: Total of 61 cases were analysed, females with age range of 23 to 64 years, mean age of 38 years. Majority of the cases presented with unilateral breast lump (92.5%). In MMSI Scoring, 15/61 (24.5%) were found with the score of 6 followed by 12/61 (19.6%) score of 8 which falls under NPBD. Total of cases 2/61 (3.2%) score of 24 while 3/61 (4.9%) with the score of 23 fell under Carcinoma breast category. Overall concordance observed between MMSI and histopathology was 59/61 cases which is 96.72%, which indicates the high degree of concordance with histopathological diagnosis. Conclusion: MMSI is a simple and reliable scoring system and can be applied on FNAC aspirates. MMSI increase the diagnostic accuracy and provide better concordance with histopathology.