Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jan;480(1):33-43.
doi: 10.1007/s00428-021-03141-2. Epub 2021 Jul 1.

Grading of invasive breast carcinoma: the way forward

C van Dooijeweert  1   2 , P J van Diest  3 , I O Ellis  4
Affiliations
Review

Grading of invasive breast carcinoma: the way forward

C van Dooijeweert et al. Virchows Arch. 2022 Jan.

Abstract

Histologic grading has been a simple and inexpensive method to assess tumor behavior and prognosis of invasive breast cancer grading, thereby identifying patients at risk for adverse outcomes, who may be eligible for (neo)adjuvant therapies. Histologic grading needs to be performed accurately, on properly fixed specimens, and by adequately trained dedicated pathologists that take the time to diligently follow the protocol methodology. In this paper, we review the history of histologic grading, describe the basics of grading, review prognostic value and reproducibility issues, compare performance of grading to gene expression profiles, and discuss how to move forward to improve reproducibility of grading by training, feedback and artificial intelligence algorithms, and special stains to better recognize mitoses. We conclude that histologic grading, when adequately carried out, remains to be of important prognostic value in breast cancer patients.

Keywords: Breast; Carcinoma; Grading; Histology.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A Tubular differentiation score 1. B Tubular differentiation score 2. C Tubular differentiation score 3
Fig. 2
Fig. 2
A Nuclear pleomorphism score 1. B Nuclear pleomorphism score 2. C Nuclear pleomorphism score 3
Fig. 3
Fig. 3
Mitotic figures
See this image and copyright information in PMC

Comment in

References

    1. Sistrunk WE, MacCarty WC. Life expectancy following radical amputation for carcinoma of the breast: a clinical and pathologic study of 218 cases. Ann Surg. 1922;75(1):61–69. - PMC - PubMed
    1. Greenough RB. Varying degrees of malignancy in cancer of the breast. Can Res. 1925;9(4):453–463.
    1. Wolff B. Histological grading in carcinoma of the breast. Br J Cancer. 1966;20(1):36–40. doi: 10.1038/bjc.1966.5. - DOI - PMC - PubMed
    1. Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer: a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957;11(3):359–377. doi: 10.1038/bjc.1957.43. - DOI - PMC - PubMed
    1. Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology. 1991;19(5):403–410. doi: 10.1111/j.1365-2559.1991.tb00229.x. - DOI - PubMed