Role of nuclear grading of breast carcinomas in fine needle aspiration specimens

Nuclear grade is one of several key prognostic factors that should be addressed in the pathologic analysis of breast carcinomas. A recent National Institutes of Health consensus conference on breast carcinoma recommended that the nuclear grade assignment should be mentioned in pathology reports on such specimens. This retrospective study assigned a nuclear grade to all positive breast aspirates that had tissue follow-up over the previous 23 months. Independent, blind grading of the tissue specimens and aspirates revealed concurrence of nuclear grade assignment in 95% of the cases. Using the same criteria for grading tissue and cytologic specimens, it was concluded that assigning a nuclear grade in breast carcinoma aspirates is done with little effort, is reproducible and, with rare exceptions, depending on sample limitations, correlates precisely with the tissue nuclear grade. Since the nuclear grade provides such important prognostic information and is a fundamental cytologic parameter, the nuclear grade should appear in fine needle aspiration biopsy reports on breast carcinomas.