Evaluation of Masood’s and Modified Masood’s Scoring Systems in the Cytological Diagnosis of Palpable Breast Lump Aspirates

Abstract

Introduction: Fine Needle Aspiration Cytology (FNAC) has a leading role in the assessment of breast lesions. Masood’s Scoring Index (MSI) and its modification (Modified Masood’s scoring index; MMSI) has been proposed to aid in sub-grouping breast lesions and to help in subsequent management. Aim: To assess and compare the diagnostic accuracy of MSI and MMSI by subsequent correlation with histopathology. Materials and Methods: The study was cross-sectional in nature and was conducted in a tertiary care setting. The study included 207 cases presenting as palpable breast lump, which had undergone FNAC and subsequent excision biopsy for histopathology. Statistical Analysis: The cases were grouped into four categories as suggested by Masood et al., (MSI) and Nandini et al., (MMSI) and concordance analysis with reference to histopathological diagnosis was done. Results: In comparison to MSI, MMSI showed better concordance with histopathological diagnosis and superior diagnostic accuracy in non-proliferative breast disease category (p-value = 0.046) as well as in proliferative breast disease without atypia category. The overall diagnostic accuracy of the cytological scoring was 97.5%, with 94.5% sensitivity and 100% specificity. Conclusion: Though both MSI and MMSI were found effective in subcategorizing breast lesions, MMSI was found to have better concordance with histopathology. Inclusion of cellular pattern and background material may further help in increasing the accuracy.

Keywords

• breast carcinoma
• fine needle aspiration cytology of breast
• non-proliferative breast disease
• proliferative breast disease