Introduction: Breast lump is the commonest presentation of breast diseases. Diagnosis of breast diseases can be made out based on history, physical examination and investigations, like cytology, histology and radiology. Several studies have shown that triple tests consisting of clinical, cytopathological and radiological examinations are more accurate, when all the three are positive; the accuracy approaches almost 100% for malignancy. Materials and methods: A 3 years retrospective study was performed in the Department of Pathology in a tertiary care centre. The cytological slides and corresponding histological slides were retrieved from the archives, and the cytological smears of palpable breasts were assessed. Statistical analysis: concordance study between conventional, MMSI and comparison with Histopathology.

Results: A total 226 patients with palpable breast lump were included in the study. A total of 18 cases were diagnosed by histopathology and there was 100% correlation between conventional and post MMSI diagnosis. A total of 144 cases were diagnosed in this category by histopathology 134 (94.4%), cases showed correlation, whereas 2 (1.4%) were under diagnosed as non proliferative breast diseases and 6 (4.2%) were over diagnosed as carcinoma by conventional cytology. Proliferative breast diseases with atypia. Out of 6 cases diagnosed on histopathology, MMSI showed 100% correlation, whereas conventional cytology 2 cases were under diagnosed as category 2 and 2 cases were correctly categorized as category 3, and 2 cases were over diagnosed as category 4. Carcinoma in situ/ Carcinoma. Out of 58 cases diagnosed by histopathology, 52 (89.7%) showed correlation with MMSI and conventional smears. 6 (10.3%)cases were under diagnosed and categorized as category 3 by MMSI. 4 cases (6.9%) were under diagnosed and categorized as category 2 and 2 cases (3.4%) were under diagnosed and categorized to category 1 by conventional cytology. Conclusion: The present study concludes that Masood’s modified scoring index has better diagnostic accuracy than conventional cytology method in diagnosing proliferative breast diseases without atypia and proliferative breast diseases with atypia, which is very useful in management of patents. 

Keywords: Breast Carcinoma; Fine Needle Aspiration Cytology; Tumor Grading; Proliferative Breast Diseases; Atypia.