Tumour Grading, DNA Ploidy and Ki-67 Index as Prognostic Markers in Fine Needle Aspirates of Breast Carcinoma

Das AK, Kapila K, Dinda AK, Verma K

Abstract

Determination of prognostic factors on FNA material is helpful in preoperative management of patients with carcinoma breast. Cytologic grading by Robinson’s method has been found to be useful as a prognostic factor. However concordance between cytologic and histologic grades is reported in only 60-80% cases. Value of using other parameters like DNA ploidy and Ki-67 as adjuncts to cytological grading in order to have a better concordance with histologic grades is not clear. This study was planned to evaluate the above hypothesis. In a prospective study, cytological grading was carried out on 52 cases of breast carcinoma using Robinson’s method and the grades compared with the histological grading by Elston and Ellis’ method. DNA ploidy was determined by image analysis and Ki-67 index was determined by immunocytochemistry on FNA material and their values correlated with corresponding cytologic and histologic grades. Robinson’s cytological grading showed a concordance of 71.2% with the histological grading. It tended to under-grade the tumors into grade I. DNA ploidy correlated with both cytologic and histologic grades while Ki-67 did not show any correlation. Addition of both DNA ploidy and Ki-67 to the cytologic grades in a decision tree approach improved the correlation with the histologic grade. Combination of DNA ploidy and Ki-67 indices improve the cytological grading with better correlation with histology.

Journal of Cytology 2005; 22 (2) : 00-00

Key words: Breast carcinoma, cytological grading, Ki-67, DNA ploidy