Role of Nuclear Morphometry as Objective Parameter to Evaluate Cytology Smears of Epithelial Breast Lesions

Abstract

Introduction: Most of the breast lesions (both benign and malignant) present as palpable swelling in the organ and Fine Needle Aspiration Cytology (FNAC) is regarded as first-line of investigation along with other ancillary tests. However, FNAC itself has its own disadvantages due to subjective nature and therefore, chance of interobserver variability especially in grey zone areas. Aim: To assess role of nuclear morphometric parameters like radius, perimeter and area to differentiate benign and malignant epithelial breast lesions so that they can be utilised as objective parameters for evaluation of cytological smears. Materials and Methods: Archived FNAC slides {LeishmanGiemsa and Papanicolaou (PAP) stained} having corresponding histopathology reports were examined under trinocular microscope with attached digital camera and computer system installed with imaging software (Scope Image 9.0) and nuclear morphometric parameters were evaluated. Statistical evaluation was done using unpaired t-test. Results: Out of total 108 cases selected, 68 were malignant lesions and 40 were benign. The mean (±SD) age of patients was 56.8 (±8.3) years and 24.5 (±5.4) years respectively. The mean nuclear radius, perimeter and area were 3.87 µm, 24.36 µm and 47.32 µm² for benign cases respectively whereas 6.67 µm, 41.92 µm and 140.75 µm² for malignant cases respectively. Conclusion: This study established that all the three nuclear morphometric parameters were significantly higher in malignant epithelial breast lesions compared to benign epithelial breast lesions (p-value <0.001). Thus, these parameters can be utilised as an objective tool to assess breast cytology smears in adjunct to other subjective features.

Keywords

• breast lump
• fine needle aspiration cytology
• morphometric evaluation