[Usefulness of cytoprognostic classification combined with histoprognostic classification in breast cancer]

Histopathological grading according to Scarff Bloom Richardson can provide powerful prognostic information. However one criticism of this system is that 60% of patients cluster in grade 2 with no clear separation of good versus bad prognosis. In an effort to solve this problem we propose to add cytological grading performed on fine needle aspirates or imprints. Indeed histological grade 2 (H2) group can be subdivided into 2 groups according to cytological grading: cytological grade 2 (C2) and grade 3 (C3). Analysis of cytometrical and proliferative features shows that H2 C3 tumors are closer from H3 C3 than from H2 C2 tumors. So, using morphological evaluation, we propose to classify breast carcinoma into 2 groups: 1 group associating histological grade 1 tumors and histological grade 2, cytological grade 2 tumors; group 2, associating histological grade 3 tumors and histological grade 2, cytological grade 3 tumors.