Study of AgNOR count and SAPA score in fine needle aspirates of breast lumps

Background: Argyrophilic Nucleolar Organizer Region technique has a potential value in the diagnosis of malignancy and can be used in cases with equivocal and inconclusive cytological picture. The purpose of this study was to evaluate mean Argyrophilic Nucleolar Organizer Region count and Subjective Argyrophilic Nucleolar Organizer Region Pattern Assessment score in fi ne needle aspirates of breast lumps. Materials and Methods: A prospective, cross sectional study consisting of 110 patients (38 malignant and 72 benign) with clinically palpable breast lumps who underwent fi ne needle aspiration followed by subsequent histopathologic examination were included. Fine Needle Aspiration smears were studied by conventional methods and silver staining for Argyrophilic Nucleolar Organizer Regions. Histopathologic diagnosis was taken as the gold standard. Results: Argyrophilic Nucleolar Organizer Region count and Subjective Argyrophilic Nucleolar Organizer Region Pattern Assessment score were helpful in differentiating benign from malignant lesions. Mean Argyrophilic Nucleolar Organizer Region count and Subjective Argyrophilic Nucleolar Organizer Region Pattern Assessment score were 2.63 ± 1.36 and 6.26 ± 1.19 respectively in benign lesions while they were 8.42 ± 2.53 and 10.05 ± 2.22 respectively in malignant lesions. With few exceptions, cases with high counts had high scores. Conclusion: Mean Argyrophilic Nucleolar Organizer Region AgNOR count and Subjective Argyrophilic Nucleolar Organizer Region Pattern Assessment score provide useful information regarding cellular proliferation. Both count and score have comparable diagnostic potential but the latter is a more convenient and rapid method for Argyrophilic Nucleolar Organizer Region evaluation. DOI: http://dx.doi.org/10.3126/jkmc.v1i1.7248 Journal of Kathmandu Medical College, Vol. 1, No. 1, Issue 1, Jul.-Sep., 2012 pp.3-9