Skip to main content

Advertisement

Log in

Can Morphological Markers of Chromosomal Instability in Fine-Needle Aspiration Cytology Aid in Cytological Grading of Breast Cancer

  • Original Article
  • Published:
Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Background

Breast cancer is a heterogeneous disease, with appreciable patterns of chromosomal alterations which include chromosomal breakage and aneuploidy.

Aim

The aim of the present study was to correlate morphological markers of chromosomal instability (CIN) with cytological grade of invasive ductal carcinoma (IDC) in FNAC specimens.

Material and Methods

This was a prospective study; we studied 153 cases of IDC diagnosed on FNAC. Quantitative estimation of CIN markers, namely micronuclei (MN), nuclear bud (NB), chromatin bridge (CB), and multipolar mitosis (MPM), was done on Giemsa-stained cellular smears. The smear was screened for CB and MPM and their count was noted, whereas MN and NB were scored per 1000 malignant cells.

Results

Of the 153 cases, 48 (31.37%) were grade I, and 47(30.72%) and 58 (37.91%) cases were grade II and III IDC, respectively. MN and NB score increased from grade I IDC (0–5 MN/1000cells) to grade II (2–14 MN/1000) and from grade II to grade III (8–18 MN/1000cells and 7–19 NB/1000cells). CB and MPM were absent in all grade I IDC. The CB and MPM were present in 55/58 (0–5 CB/smear) and 49/58 (0–6 MPM/ smear) grade II and III IDC cases, respectively. A significant difference was noted between mean values of CIN markers between all the grades of IDC (p < 0.05).

Conclusion

The present study found a strong correlation of increasing assay of CIN markers with an increasing cytological grade of IDC. Since these markers can easily be analyzed in cytological material in routine reporting, the incorporation of these CIN markers in cytological grading parameters of BC by light microscopy will add to its strength and enhance its reproducibility, especially in low-cost and low-resource setup.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA A Cancer J Clin. 2019;69:7–34.

    Article  Google Scholar 

  2. Atun R, Cavalli F. The global fight against cancer: challenges and opportunities. Lancet. 2018;391:412–3.

    Article  Google Scholar 

  3. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  Google Scholar 

  4. Simonetti G, Bruno S, Padella A, Tenti E, Martinelli G. Aneuploidy: cancer strength or vulnerability? Int J Cancer. 2019;144:8–25.

    Article  CAS  Google Scholar 

  5. Bhatia A, Kumar Y. Cancer cell micronucleus: an update on clinical and diagnostic applications. APMIS acta pathologica, microbiologica, et immunologica Scandinavica. 2012;121:10.

    Google Scholar 

  6. Alvia S, Bagadi SA, Dubey US, Saxena S. Epidemiology of breast cancer in Indian women. Asia Pac J Clin Oncol. 2017;13:289–95.

    Article  Google Scholar 

  7. Alexander A, Kaluve R, Prabhu JS, Korlimarla A, Srinath BS, Manjunath S, Patil S, Gopinath KS, Shridhar TS. The impact of breast cancer on the patient and the family in Indian perspective. Indian J Palliat Care. 2019;25:66–72.

    PubMed  PubMed Central  Google Scholar 

  8. Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risk of breast and ovarian cancer associated with BRCA 1 or BRCA 2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117–30.

    Article  CAS  Google Scholar 

  9. McGranahan N, Burrell RA, Endesfelder D, Novelli MR, Swanton C. Cancer chromosomal instability: therapeutic and diagnostic challenges. EMBO Rep. 2012;13:528–38.

    Article  CAS  Google Scholar 

  10. Verma S, Dey P. Correlation of morphological markers of chromosomal instability in fine needle aspiration cytology with grade of breast cancer. Cytopathol Off J Br Soc Clin Cytol. 2014;25(4):259–326.

    Article  CAS  Google Scholar 

  11. Tyagi R, Dey P, Uppal R, Rajwanshi A. Analysis of morphological markers of chromosomal instability in ascitic fluid. Diagn Cytopathol. 2015;43(10):855–8.

    Article  Google Scholar 

  12. Lindberg HK, Wang X, Jarventaus S, Falck GCM, Norppa H, Fenech M. Origin of nuclear buds and micronuclei in normal and folate derived human lymphocytes. Mutat Res Fundam Mol Mech Mutagen. 2007;617(1–2):33–45.

    Article  CAS  Google Scholar 

  13. Thomas P, Holland N, Bolognesi C, Kirsch-Volders M, Bonassi S, Zeiger E, et al. Buccal micronucleus cytome assay. Nat Proctoc. 2009;4(6):825–67.

    Article  CAS  Google Scholar 

  14. Robinson IA, McKee G, Kissin MW. Typing and grading of breast carcinoma on fine-needle aspiration: is this clinically useful information? Diagn Cytopathol. 1995;13:260–5.

    Article  CAS  Google Scholar 

  15. Nicholson JM, Cimini D. Cancer karyotypes: survival of the fittest. Front Oncol. 2013;3:148.

    Article  Google Scholar 

  16. McClelland SE. Role of chromosomal instability in cancer progression. Endocr Relat Cancer. 2017;24:T23–31.

    Article  CAS  Google Scholar 

  17. Randon NV, Vargas-Rondón N, Villegas VE, Rondón-Lagos M. The role of chromosomal instability in cancer and therapeutic responses. Cancers. 2018;10(1):4.

    Article  Google Scholar 

  18. Kwei KA, Kung Y, Salari K, Holcomb IN, Pollack JR. Genomic instability in breast cancer: pathogenesis and clinical implications. Mol Oncol. 2010;4(3):255–66.

    Article  CAS  Google Scholar 

  19. Heddle JA, Fenech M, Hayashi M, MacGregor JT. Reflections on the development of micronucleus assays. Mutagenesis. 2011;26:3–10.

    Article  CAS  Google Scholar 

  20. Sylvia MT, Baskaran L, Bhat RV. Micronucleus study on breast cytology aspirate smears and its diagnostic utility. J Cytol. 2018;35:22–6.

    Article  Google Scholar 

  21. Samanta S, Dey P, Nijhawan R. The role of micronucleus scoring in fine needle aspirates of ductal carcinoma of the breast. Cytopathology. 2011;22(2):111–4.

    Article  CAS  Google Scholar 

  22. Hemalatha A, Suresh TN, Harendra Kumar ML. micronuclei in breast aspirates scoring them helpful? J Can Res Ther. 2014;10:309–11.

    Article  CAS  Google Scholar 

  23. Gisselsson D. Tumour morphology: interplay between chromosome aberrations and founder cell differentiation. Histol Histopathol. 2002;17:1207–12.

    CAS  PubMed  Google Scholar 

  24. Thomas P, Umegaki K, Fenech M. Nucleoplasmic bridges are a sensitive measure of chromosome rearrangement in the cytokinesis block micronucleus assay. Mutagenesis. 2003;18:187–94.

    Article  CAS  Google Scholar 

  25. Matsuda Y, Aida J, Ishikawa N, Takubo K, Ishiwata T, Arai T. Morphological markers of chromosomal instability. In: Chromosomal abnormalities: a hallmark manifestation of genomic instability. Intech. 2017; https://doi.org/10.5772/67416.

  26. Kalatova B, Jesenska R, Hlinka D, Dudas M. Tripolar mitosis in human cells and embryos: occurrence, pathophysiology and medical implications. Acta Histochem. 2015;117(1):111–25.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to V. B. Shivkumar.

Ethics declarations

Conflict of interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jain, B., Atram, M. & Shivkumar, V.B. Can Morphological Markers of Chromosomal Instability in Fine-Needle Aspiration Cytology Aid in Cytological Grading of Breast Cancer. Indian J Gynecol Oncolog 19, 57 (2021). https://doi.org/10.1007/s40944-021-00557-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40944-021-00557-1

Keywords

Navigation