Value of scoring system in classification of proliferative breast disease on fine needle aspiration cytology

Background: Fine needle aspiration cytology (FNAC) breast is generally considered as a rapid, safe and reliable diagnostic tool to distinguish benign from malignant breast lesions. Masood's Scoring Index has been proposed to categorize the breast lesions so as to help in surgical management. Objectives : To find out the usefulness of Modified Masoods scoring Index (MMSI) in proliferative breast diseases. Materials and Methods: This is a prospective study, done over period of one year 2012 to 2013, which includes fifty cases of palpable breast lesions with cytological diagnosis, followed by histological confirmation on biopsy. MMSI was applied on corresponding FNAC aspirates. Breast lesions were categorized into four groups, non proliferative breast disease, proliferative breast disease (PBD) without atypia, PBD with atypia and carcinoma breast. Results: Out of total 50 cases, age group ranged from 17-64 years. Modification of Masoods scoring system by shifting of score 9 and 10 from category I to category II, was found to be easily reproducible scoring method of breast lesions as it has improved the diagnostic accuracy of PBD. Conclusion: FNAC of breast is highly sensitive and specific modality for distinguishing benign and malignant lesions but its role in diagnosing proliferative breast lesions is debatable. MMSI can be applied on FNAC aspirates in stepwise manner after cytomorphological assessment to improve diagnostic accuracy of PBD without atypia.