Journal de cytologie et d'histologie

Morphometric Study of Nuclei in FNAC of Breast Lesion and its Role in Diagnosis of Malignancy

Abstract

Dibyajyoti Boruah, V Srinivas and SG Belagavi

Introduction: Cytological features obtained from fine needle aspiration cytology(FNAC) are very essential for the preoperative diagnosis in breast carcinoma. The quantitative evaluation of nuclear size and shape using FNAC material can be utilized as a diagnostic tool in breast tumor. The main objectives of our study were (a) to evaluate major axis (MAJX), minor axis (MINX), nuclear area (NA), nuclear perimeter (NP) and nuclear aspect ratio (NAR) using morphometric techniques, (b) to compare these nuclear parameters with their variability in benign and malignant cases and evaluate suitable cut off values and (c) to study the correlation of these parameters with cytological grades.
Materials and Methods: Nuclear parameters were assessed in 50 cases of invasive ductal carcinoma and 50 cases of benign breast tumors by image morphometric technique on FNAC slides and statistical analysis was performed.
Results: Mean MAJX, MINX, NA, NP and their variability were significantly greater (p<0.001) in malignant cases than the benign unlike NAR. All nuclear parameters showed positive correlation with their variability. Cytological grade exhibited mild positive correlation with MAJX, MINX, NA and NP except NAR. The cut off values with sensitivity=1.00 for the differentiation of malignant from benign were: (a) MAJX>10.70 micron (specificity=0.98), (b) MINX>7.53 micron (specificity=0.94), (c) NA>60.61 micron2 (specificity=0.98) and (d) NP>27.81 micron (specificity=0.96).
Conclusion: Morphometric parameters related to nuclear size and variability evaluated from FNAC material were significantly larger in malignant cases than the benign and they can be gainfully exploited in the diagnosis of breast carcinoma. Again these parameters showed mild positive correlation with the cytological grades.