Bansal Cherry, Singh U S, Misra Sanjeev, Sharma Kiran Lata, Tiwari Vandana, Srivastava A N
Department of Pathology, Era's Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Cytojournal. 2012;9:4. doi: 10.4103/1742-6413.92550. Epub 2012 Jan 31.
Fine needle aspiration (FNA) is a quick, minimally invasive procedure for evaluation of breast tumors. The Scarff-Bloom-Richardson (SBR) grade on histological sections is a well-established tool to guide selection of adjuvant systemic therapy. Grade evaluation is possible on cytology smears to avoid and minimize the morbidity associated with overtreatment of lower grade tumors.
The aim was to test the hypothesis whether breast FNA from the peripheral portion of the lesion is representative of Scarff-Bloom-Richardson grade on histopathology as compared to FNA from the central portion.
Fine-needle aspirates and subsequent tissue specimens from 45 women with ductal carcinoma (not otherwise specified) were studied. FNAs were performed under ultrasound guidance from the central as well as the peripheral third of the lesion for each case avoiding areas of necrosis/calcification. The SBR grading was compared on alcohol fixed aspirates and tissue sections for each case.
Comparative analysis of SBR grade on aspirates from the peripheral portion and histopathology by the Pearson chi-square test (χ(2) =78.00) showed that it was statistically significant (P<0.001) with 93% concordance. Lower mitotic score on aspirates from the peripheral portion was observed in only 4 out of 45 (9%) cases. The results of the Pearson chi-square test (χ(2) = 75.824) with statistically significant (P=0.000).
This prospective study shows that FNA smears from the peripheral portion of the lesion are representative of the grading performed on the corresponding histopathological sections. It is possible to score and grade by SBR system on FNA smears.
细针穿刺抽吸术（FNA）是一种用于评估乳腺肿瘤的快速、微创的方法。组织学切片上的斯卡夫-布卢姆-理查森（SBR）分级是指导辅助性全身治疗选择的一种成熟工具。在细胞学涂片上进行分级评估，可避免和减少与低级别肿瘤过度治疗相关的发病率。
目的是检验以下假设，即与从病变中央部分进行的FNA相比，从病变周边部分进行的乳腺FNA在组织病理学上是否代表斯卡夫-布卢姆-理查森分级。
对45例导管癌（未另作说明）女性的细针穿刺抽吸物及随后的组织标本进行了研究。对每例患者在超声引导下从病变的中央以及周边三分之一处进行FNA，避开坏死/钙化区域。对每例患者的酒精固定抽吸物和组织切片的SBR分级进行比较。
通过Pearson卡方检验（χ(2)=78.00）对周边部分抽吸物的SBR分级与组织病理学进行比较分析，结果显示具有统计学意义（P<0.001），一致性为93%。在45例（9%）病例中，仅4例观察到周边部分抽吸物的有丝分裂分数较低。Pearson卡方检验结果（χ(2)=75.824）具有统计学意义（P=0.000）。
这项前瞻性研究表明，病变周边部分的FNA涂片代表了在相应组织病理学切片上进行的分级。在FNA涂片上可以根据SBR系统进行评分和分级。
