Role of cytological grading in the management of breast lump

Objective: To evaluate the fine needle aspiration (FNA) smears of the breast lumps using the cytological evaluation system (C1 to C5) as practiced in the National Breast Screening Programme in the UK. Results: A total of 75 patients of lump breast were included in the project. The age range was 13-75 years with a peak incidence in the 3rd decade. There were 70 (93.3%) females and 5 (6.6%) male cases. Of the total 75 cases, 7 were designated C1, 45 C2, 5 C3, 7 C4 and 11 C5. In surgical biopsies, all the 45 cases designated as C2 proved to be benign with fibroadenoma and fibrocystic change as predominant lesions. All 11 designated C5 proved to be malignant; whereas, of the 5 cases labeled as C3, 4 were benign and one was malignant and out of seven C4 cases, 5 came out as malignant and 2 proved benign. Conclusion: the fine needle aspiration of lump breast has a sensitivity of 94.1%, specificity of 96.0% and accuracy of 95.5%. The C1-C5 grading system is practical, flexible, and gives room for expression of opinion by cytopathologist and easily interpreted by clincians. (author)