Role of Computer Assisted Nuclear Morphometric Analysis in Grading of Infiltrating Ductal Carcinoma of Breast (Nos Type) and Correlation with Established Prognostic Markers

Background: Grading of Infiltrating Duct Carcinoma (IDC) of the breast forms one of the very important prognostic indicators of breast cancer. The grading system that is well established is the Nottingham modification of Bloom Richardson’s grading system which takes into account architectural features (mainly tubule formation), the degree of nuclear atypia and evaluation of mitotic activity. In this system, only the mitotic activity is evaluated in a quantitative manner, while the evaluation of nuclear pleomorphism and tubule formation is still dependent on the pathologist's subjective factors. To improve the clinical value of malignancy grading, it has been suggested to quantify nuclear pleomorphism by measuring nuclear features such as area, perimeter and diameters. Various attempts quantitating these changes (particularly the nuclear aberration) have been made by computer analysis. Computer assisted nuclear morphometry helps in objective grading of breast cancer and reduces the interobserver variability. Objectives: The aim of the study was to quantitate the nuclear pleomorphism in IDC (NOS) of breastby computer assisted nuclear morphometry and to correlate values obtained with other established prognostic indicators. Materials and methods: Sixty cases of mastectomy specimens with proved histological diagnosis of IDC (NOS) were subjected to the study. Computerised Nuclear morphometry was done by using Olympus BX-41 research microscope with jenoptix (Germany) progress CCD camera with progress capture pro imaging software. Fifty nuclei from each case were outlined using the sketch command under 0.00001 increments by the computer mouse. Results: As the grade of tumour increased, the morphometric values increased. A statistically significant correlation was obtained between the morphometric size parameters and histological prognosticators. No correlation was found between morphometric shape parameters and prognostic factors. Conclusion: Computer assisted morphometry can be used in objective grading and standardizing grading performance between different laboratories.