• SHIV KUMAR Department of Pathology, Government Medical College, Patiala, Punjab, India.
  • Ninder Kumar Department of Pathology, Government Medical College, Patiala, Punjab, India.
  • RAMESH KUMAR Department of Pathology, Government Medical College, Patiala, Punjab, India.
  • HARNAM SINGH REKHI Department of Surgery, Government Medical College, Patiala, Punjab, India.



Carcinoma breast, Robinson’s grading, Nottingham’s modified Bloom Richardson grading, Fine needle aspiration cytology


Objectives: Carcinoma breast is most commonly diagnosed cancer in women. Fine-needle aspiration cytology (FNAC) and histopathology play very important role in diagnosing breast cancer. Main objective of this study is to compare the cytological and histopathological grading in invasive ductal carcinoma of breast.

Methods: The study was conducted in the Department of Pathology, Government Medical College, Patiala. Fifty patients with palpable breast lump were selected. The age of whom varied from 30 to 86 years. FNAC was done, smears were prepared and stained with Romanowsky and Papanicolaou stains. Cytological grading was done according to Robinson’s method. After surgery, the results were compared with histological grading according to Nottingham’s Modification of Bloom–Richardson method.

Results: On cytological grading of 50 cases, 25 (50%) cases were graded as Grade II, 21 (42%) as Grade I, and 4 (8%) as Grade III. Whereas on histological grading, Grades I, II and III tumors were 17 (34%), 22 (44%), and 11 (22%), respectively. Overall concordance of cytological grading with histological grading was 76% with a kappa value of 0.605 and p<0.001.

Conclusion: The study showed that the cytological grade correlates well with the histological grade. Cytological grade can be of great value in evaluating the aggressiveness of tumor, neoadjuvant chemotherapy and can be used as a prognostic factor for better management of patients.


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Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-49. doi: 10.3322/caac.21660

Available from: populations/900-world-fact-sheets.pdf

Susan CL. The breast. In: Robbins SL, Cotran RS, Kumar V, Abbas AK, Fausto N, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2017. p. 1053.

Roychowdhury M. NST (Ductal). Available from: https://www. [Last accessed on 2022 Jun 12].

Robinson IA, McKee G, Nicholson A, D’Arcy J, Jackson PA, Cook MG, et al. Prognostic value of cytological grading of fine-needle aspirates from breast carcinomas. Lancet 1994;343:947-9. doi: 10.1016/s0140- 6736(94)90066-3, PMID 7909010

Mouriquand J, Pasquier D. Fine needle aspiration of breast carcinoma: A preliminary cytoprognostic study. Acta cytol 1980;24:153-9. PMID 6245554

Simpson JF, Gray R, Dressler LG, Cobau CD, Falkson CI, Gilchrist KW, et al. Prognostic value of histologic grade and proliferative activity in axillary node-positive breast cancer: Results from the eastern cooperative oncology group companion study, EST 4189. J Clin Oncol 2000;18:2059-69. doi: 10.1200/JCO.2000.18.10.2059, PMID 10811671

Saha K, Raychaudhuri G, Chattopadhyay BK, Das I. Comparative evaluation of six cytological grading systems in breast carcinoma. J Cytol 2013;30:87-93. doi: 10.4103/0970-9371.112647, PMID 23833396

Nandakumar A. National cancer registry programme. Consolidated Report of the Population-based Cancer Registries. New Delhi, India: Indian Council of Medical Research; 1990. p. 96.

Gupta P, Sharma RG, Verma M. Review of breast cancer cases in Jaipur region. J Indian Med Assoc 2002;100:282-3.

Briffod M, Le Doussal V, Spyratos F. Cytologic nuclear grading of fine needle cytopunctures of breast carcinoma. Comparison with histologic nuclear grading and image cytometric data. Anal Quant Cytol Histol 1997;19:114-22. PMID 9113304

Khan MZ, Haleem A, Al Hassani H, Kfoury H. Cytopathological grading, as a predictor of histopathological grade, in ductal carcinoma (NOS) of breast, on air‐dried Diff‐Quik smears. Diagn Cytopathol 2003;29:185-93. doi: 10.1002/dc.10285, PMID 14506669

Meena SP, Hemrajani DK, Joshi N. A comparative and evaluative study of cytological and histological grading system profile in malignant neoplasm of breast--an important prognostic factor. Indian J Pathol Microbiol 2006;49:199-202. PMID 16933714

Phukan JP, Sinha A, Deka JP. Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading. South Asian J Cancer 2015;4:32-4. doi: 10.4103/2278-330X.149948, PMID 25839018

Deshmukh SD, Khandelwal R, Khaparde SH, Shinde BB, Ayesha N, Khonde D. Robinson’s cytological grading on fine needle aspirates (FNAC) of breast cancers and its correlation with histopathological grading. Int J Clin Diagn Pathol 2020;3:376-9. doi: 10.33545/ pathol.2020.v3.i1f.200

Handa U, Kumar A, Kundu R, Dalal U, Mohan H. Evaluation of grading and hormone receptor immunostaining on fine needle aspirates in carcinoma breast. J Cytol 2015;32:1-5. doi: 10.4103/0970- 9371.155222, PMID 25948935

Pal S, Gupta ML. Correlation between cytological and histological grading of breast cancer and its role in prognosis. J Cytol 2016;33:182-6. doi: 10.4103/0970-9371.190449, PMID 28028331

Jayasree KA, Mini B, Kamala VV. Cytological grading on aspirates of breast carcinoma and its correlation with histopathological grading. J Evid Based Med Healthc 2020;7:1880-3.

Jain M, Agarwal K, Thomas S, Singh S, Bhargava V. Critical appraisal of cytological nuclear grading in carcinoma of the breast and its correlation with ER/PR expression. J Cytol 2008;25:58. doi: 10.4103/0970-9371.42445

Pandya AN, Shah NP. Comparative evaluation of Robinson’s cytological grading with Elston and Ellis’ Nottingham modification of bloom Richardson histopathology grading for breast carcinoma. Natl J Community Med 2012;3:491-5.

Sood N, Nigam JS, Yadav P, Rewri S, Sharma A, Omhare A, et al. Comparative study of cytomorphological Robinson’s grading for breast carcinoma with modified bloom-Richardson histopathological grading. Pathol Res Int 2013;2013:146542. doi: 10.1155/2013/146542, PMID 24187646



How to Cite

SHIV KUMAR, Ninder Kumar, RAMESH KUMAR, and HARNAM SINGH REKHI. “COMPARATIVE EVALUATION OF CYTOLOGICAL AND HISTOPATHOLOGICAL GRADING IN INVASIVE DUCTAL CARCINOMA BREAST: A CROSS-SECTIONAL STUDY”. Asian Journal of Pharmaceutical and Clinical Research, vol. 15, no. 7, July 2022, pp. 163-6, doi:10.22159/ajpcr.2022.v15i7.44839.



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