Grocott’s methenamine silver stain mediated micronuclei detection: A diagnostic tool for breast lesion classification

Gayathri MN, Shameel MZ, Nisarga MD, Annapoorna GR, Shashidhar HB

Pdf Page Numbers :- 167-172

Gayathri MN¹, Mohammed Azm Shameel^1,*, Nisarga MD¹, Annapoorna GR¹ and Shashidhar HB¹

¹Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India.

*Corresponding author: Mohammed Azm Shameel, Department of Pathology, Mysore Medical College and Research Institute, Mysore, Karnataka 570001, India. Email: azmshameel2857@gmail.com

Received 20 January 2025; Revised 3 March 2025; Accepted 11 March 2025; Published 19 March 2025

Citation: Gayathri MN, Shameel MZ, Nisarga MD, Annapoorna GR, Shashidhar HB. Grocott’s methenamine silver stain mediated micronuclei detection: A diagnostic tool for breast lesion classification. J Med Sci Res. 2025; 13(2):167-172. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-29

Copyright: © 2025 Gayathri MN et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Micronuclei (MN), markers of chromosomal instability and genetic damage, are emerging as reliable biomarkers in fine needle aspiration cytology (FNAC) of breast lesions. MN scoring aids in distinguishing benign from malignant lesions and may assist in diagnosing borderline cases, improving the accuracy and objectivity of cytological evaluation. This study aims to assess the correlation between MN scoring and epithelial breast lesions and evaluate its utility as a supplementary diagnostic tool in challenging cases.

Materials and methods: This prospective study was conducted over one year at Mysore Medical College and Research Institute, involving 208 FNAC smears of breast lesions. Inclusion and exclusion criteria were strictly followed. MN scoring was done using Grocott’s Methenamine Silver stain. Cases were categorized according to the International Academy of Cytology Yokohama System, and malignant cases were graded using Robinson’s criteria. Two independent pathologists scored the slides to ensure good interobserver reliability.

Results: Among the 208 cases, 69.7% were benign, predominantly fibroadenomas. MN scores were low in benign lesions (0.3–2.0), increased in atypical and suspicious lesions (3.4 and 5.2), and highest in malignant cases, particularly poorly differentiated tumors (up to 17.4). A positive correlation was observed between MN score and malignancy, with aggressive tumors showing higher genetic instability. Benign lesions were predominantly seen in younger individuals, while the malignant cases showed an upward trend with increasing age.

Conclusion: MN scoring correlates strongly with malignancy and provides an objective, reproducible tool in breast cytology, especially valuable in borderline cases such as atypical hyperplasia, enhancing diagnostic confidence in FNAC.

Keywords: FNAC; breast lesion; micronucleus; Grocott’s methenamine; silver stain