Value of Robinson’s Scoring System and Agnor Score in Classification of Proliferative and Malignant Epithelial Breast Diseases on FNAC.

Francis Asir Joseph, J (2013) Value of Robinson’s Scoring System and Agnor Score in Classification of Proliferative and Malignant Epithelial Breast Diseases on FNAC. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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Breast Carcinoma Is One Of The Most Common Non-Skin Malignancies And Is The Leading Cause Of Death In Women, Comprising About 22.9% Of All Cancers In Woman Worldwide1. However, Noncancerous Conditions Of The Breast Are Far More Common Than Carcinomas. The Breasts Are Composed Of Specialized Epithelium And Stroma That Gives Rise To Both Benign And Malignant Neoplasm. The Incidence Of Female Breast Cancer Is Rising Rapidly Between The Age Group Of 35 To 50 Years Worldwide. Invasive Ductal Carcinoma Comprises The Largest Group Of Malignancy Constituting About 65% - 80% Of All Breast Carcinomas2. The Advent Of The Medical Science Has Conquered Many Of The Infectious Diseases That Formerly Destroyed Large Populations Of The Mankind, But Cancer Still Remains As An Unconquerable Disease Of The Nonepidemic Kind. It’s Ironic And Tragic That Lesions Arising From The Breast, Readily Accessible To Self-Examination And Clinical Diagnosis, Continue To Take A Heavy Toll On The Female Gender. Clinical Examination, Mammographic Imaging Studies And Fine Needle Aspiration Cytology Have Traditionally Been Used As A Triple Assessment Tool For Evaluation And Diagnosis Of The Breast Lesions2. Two Cytological Methods That Have Been Used To Obtain Material From Breast Lesions Are Aspiration Of Secretions From The Nipple And Fine Needle Aspiration Cytology Of Breast Lesions. Aspiration Cytology Of Nipple Secretions Is Only Of A Limited Use, Whereas The Application Of Fine Needle Aspiration Undoubtedly Has A Major Influence On The Evaluation And Diagnosis Of The Breast Lesions2. Fine Needle Aspiration Offers A Rapid And Safe Diagnostic Approach Which Is Usually Being Employed As An Outpatient Procedure Without Any Need For Anaesthesia. In The Experienced Hands This Technique Is Highly Reliable And Promptness Of Diagnosis Alleviates Patient Anxiety And Allows Time To Plan For Definitive Management. The Average Sensitivity Of This Procedure Is About 87%, The Specificity And Positive Predictive Values Are Nearly Close To 100%, While The Negative Predictive Value Still Hovers Around 60%2. Even Then The Lesions Of The Breast Pose Various Diagnostic Difficulties In Distinguishing Benign From Malignant Lesions. Since Most Of The Malignant Neoplasm Show Increased Proliferative Activity, Research Had Been Directed Towards Finding A Reliable Proliferative Marker. Mitotic Index Forms One Of The Oldest And Reliable Proliferation Markers Since The Advent Of Light Microscopy, But Its Reproducibility Has Been Greatly Debated3. Since Then Various Such Markers Has Been Identified. Nucleolar Organizer Regions (Nor’s) Forms One Of The Earliest Proliferation Marker Discovered And Utilised By Ploton Et Al. In 1986 To Distinguish Benign From Malignant Neoplasm, The Latter Showing More Abundant Nors4. The Agnor Staining Is Quiet Simple And Easily Affordable Compared To Other Expensive And Complex Procedures Like Enumeration Of S Phase Fraction (Spf), Proliferating Cell Nuclear Antigen (Pcna), Ki - 67 Index And Mib – 1 Index. “Earlier The Diagnosis Of The Lesion Better Is The Prognosis”. Having This Concept In Our Mind, Our Present Study Has Been Conducted To Assess The Accuracy Of Agnor As A Proliferation Marker In Differentiating Benign And Malignant Epithelial Breast Lesions On Fine Needle Aspiration Cytology.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Robinson’s Scoring System ; Agnor Score ; Classification ; Proliferative ; Malignant Epithelial ; Breast Diseases FNAC.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jun 2017 10:29
Last Modified: 29 Jun 2017 10:29

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