Department of Pathology, Dayanand Medical College & Hospital, Ludhiana, India.
Breast J. 2019 May;25(3):434-438. doi: 10.1111/tbj.13239. Epub 2019 Apr 10.
Fine needle aspiration cytology has long been an accepted diagnostic modality in combination with physical examination and mammography to investigate breast lesions. In the present era, more proficient methods such as stereotactic mammographically guided breast biopsy is the preferred choice, however, in low resource setting, FNAC still remains the most cost effective and sampling modality to diagnose breast cancer. With the intention to evaluate the efficacy and limitations of FNAC in evaluation of breast lesions in low resource setting, we employed the Masood's cytological staging system to stratify the breast lesions and correlate them with histopathology wherever possible. All breast lesions aspirates were analyzed and classified according to the Masood's cytological scoring system and correlated with histopathological findings wherever adequate material was available. A total of 776 patients were studied of which 23 aspirates were unsatisfactory, 120 aspirates were categorized as inflammatory breast disease. Six hundred and thirty-three cases were classified according to Masood's cytological system. Nonproliferative breast diseases (Group I) encompassed maximum cases with 55% followed by carcinoma in situ and invasive cancers (Group IV) with 39% and proliferative breast disease without atypia (Group II) and with atypia (Group III) which had equal number of cases constituting 2.4% each. Cyto-histopathological correlation done in 102 cases revealed 100% concordance in group IV and 75% concordance in group III while it could not be performed in Group I and II as no histopathological specimen was available in those patients. Masood Cytological grading for breast aspirates is a reliable and an easily reproducible system which can be used to formulate appropriate treatment protocols in cases presenting with breast lesions.
细针穿刺细胞学检查长期以来一直是一种被接受的诊断方式，与体检和乳房 X 线摄影相结合，用于检查乳房病变。在当前时代，更熟练的方法，如立体定向乳腺引导下活检，是首选，但在资源匮乏的情况下，FNAC 仍然是诊断乳腺癌最具成本效益和采样方式。为了评估 FNAC 在资源匮乏环境下评估乳房病变的疗效和局限性，我们采用了 Masood 的细胞学分期系统对乳房病变进行分层，并尽可能与组织病理学相关联。所有乳房病变的抽吸物均根据 Masood 的细胞学评分系统进行分析和分类，并在有足够材料的情况下与组织病理学发现相关联。共研究了 776 例患者，其中 23 例抽吸物不满意，120 例抽吸物为炎症性乳腺疾病。633 例病例根据 Masood 的细胞学系统进行分类。非增生性乳腺疾病（第 I 组）最多，占 55%，其次是原位癌和浸润性癌（第 IV 组）占 39%，增生性乳腺疾病无不典型（第 II 组）和有不典型（第 III 组）各占 2.4%。在 102 例病例中进行了细胞组织病理学相关性研究，结果显示第 IV 组的 100%一致性和第 III 组的 75%一致性，而在第 I 组和第 II 组中无法进行，因为这些患者没有组织病理学标本。乳房抽吸物的 Masood 细胞学分级是一种可靠且易于复制的系统，可用于制定有乳房病变的患者的适当治疗方案。
