Cytological scoring of breast lesions and comparison with histopathological findings

Background-Cytological assessment using various morphological parameters helps to segregate breast lesions in FNAC into different categories.The prognosis and the line of management of each category differ accordingly.Aim-The present study aims at assessing the validity of Modified Masood's Scoring Index (MMSI) by the evaluation of cytomorphological features of various breast lesions compared with histopathological findings.Methods-This was a cross sectional study done in 65 female patients with palpable or non palpable breast lesions, undergoing FNAC and biopsy over a period of eighteen months from 1S1 December 2012 to 31s1 May 2014.Modified Masood 's Scoring Index (MMSI) categorizes breast lesions, based on six cytological parameters into different categories such as Non proliferative breast disease (NPBD), Proliferative breast disease (PBD) without atypia, PBD with atypia and malignancy.The findings are compared with the gold standard histopathological diagnosis.Results -Of the total 65 cases, all cases in MMSI category I and IV showed good histopathological correlation.The agreement between MMSI and histopathology was 93.8% which is more, as compared to 72.3% agreement between cytology without scoring and histopathology.MMSI has increased the diagnostic accuracy of FNAC to 93.8% from 80%.Conclusion-Though the number of cases in category II and III were few, majority of them were found to be malignant, on histology.Therefore it is important to identify these categories and refer them for excision biopsy at the right time.The advantages of scoring include increased diagnostic accuracy and no false positive cases of malignancy.