Significance of nuclear morphometry as a diagnostic tool in fine-needle aspirates of breast masses

Breast carcinoma ranks one among the leading causes of cancer related morbidity and mortality in Indian women closely following carcinoma cervix in order of incidence. Fine needle aspiration cytology has emerged as one of the preliminary investigations besides mammography and clinical examination for the initial assessment of breast masses. Nuclear morphometry can be used as a quantitative adjuvant to FNAC in diagnosing breast lesions, especially the ones in the “gray zone”. Objectives: The aim of this study was to assess the utility of nuclear morphometry as an adjuvant in the cytological diagnosis, categorization of breast lesions and grading of malignant lesions. Materials and Methods: Nuclear parameters were assessed in fine needle aspirates of 49 cases, for which histopathological correlation was available. Morphometric parameters analyzed were nuclear area, nuclear perimeter, minimal nuclear diameter, maximum nuclear diameter, axis ratio, nuclear shape factor and nuclear compactness. Results: Morphometric parameters showed progressive and significant increase in nuclear size parameters from benign to malignant lesions. Nuclear shape parameters also showed a significant increase from grade I to grade III malignant lesions. However these shape factors could not be used to differentiate benign and malignant lesions in our study. Conclusion: Nuclear morphometry is a valuable tool in diagnosis of breast masses. It provides data in a more objective and reproducible form unlike the conventional cytological analysis.