PURPOSE: The three strongest prognostic determinants in operable breast cancer used in routine clinical practice are lymph node (LN) stage, primary tumor size, and histologic grade. However, grade is not included in the recent revision of the TNM staging system of breast cancer as its value is questioned in certain settings. MATERIALS AND METHODS: This study is based on a large and well-characterized consecutive series of operable breast cancer (2,219 cases), treated according to standard protocols in a single institution, with a long-term follow-up (median, 111 months) to assess the prognostic value of routine assessment of histologic grade using Nottingham histologic grading system. RESULTS: Histologic grade is strongly associated with both breast cancer-specific survival (BCSS) and disease-free survival (DFS) in the whole series as well as in different subgroups based on tumor size (pT1a, pT1b, pT1c, and pT2) and LN stages (pN0 and pN1 and pN2). Differences in survival were also noted between different individual grades (1, 2, and 3). Multivariate analyses showed that histologic grade is an independent predictor of both BCSS and DFS in operable breast cancer as a whole as well as in all studied subgroups. CONCLUSION: Histologic grade, as assessed by the Nottingham grading system, provides a strong predictor of outcome in patients with invasive breast cancer and should be incorporated in breast cancer staging systems.
PURPOSE: The three strongest prognostic determinants in operable breast cancer used in routine clinical practice are lymph node (LN) stage, primary tumor size, and histologic grade. However, grade is not included in the recent revision of the TNM staging system of breast cancer as its value is questioned in certain settings. MATERIALS AND METHODS: This study is based on a large and well-characterized consecutive series of operable breast cancer (2,219 cases), treated according to standard protocols in a single institution, with a long-term follow-up (median, 111 months) to assess the prognostic value of routine assessment of histologic grade using Nottingham histologic grading system. RESULTS: Histologic grade is strongly associated with both breast cancer-specific survival (BCSS) and disease-free survival (DFS) in the whole series as well as in different subgroups based on tumor size (pT1a, pT1b, pT1c, and pT2) and LN stages (pN0 and pN1 and pN2). Differences in survival were also noted between different individual grades (1, 2, and 3). Multivariate analyses showed that histologic grade is an independent predictor of both BCSS and DFS in operable breast cancer as a whole as well as in all studied subgroups. CONCLUSION: Histologic grade, as assessed by the Nottingham grading system, provides a strong predictor of outcome in patients with invasive breast cancer and should be incorporated in breast cancer staging systems.
Authors: Arvydas Laurinavicius; Benoit Plancoulaine; Allan Rasmusson; Justinas Besusparis; Renaldas Augulis; Raimundas Meskauskas; Paulette Herlin; Aida Laurinaviciene; Abir A Abdelhadi Muftah; Islam Miligy; Mohammed Aleskandarany; Emad A Rakha; Andrew R Green; Ian O Ellis Journal: Virchows Arch Date: 2016-01-27 Impact factor: 4.064
Authors: P Sinn; S Aulmann; R Wirtz; S Schott; F Marmé; Z Varga; A Lebeau; H Kreipe; A Schneeweiss Journal: Geburtshilfe Frauenheilkd Date: 2013-09 Impact factor: 2.915
Authors: Elizabeth A Mittendorf; Karla V Ballman; Linda M McCall; Min Yi; Aysegul A Sahin; Isabelle Bedrosian; Nora Hansen; Sheryl Gabram; Thelma Hurd; Armando E Giuliano; Kelly K Hunt Journal: J Clin Oncol Date: 2014-12-08 Impact factor: 44.544
Authors: Paolo Belli; Melania Costantini; Enida Bufi; Giuseppe Giovanni Giardina; Pierluigi Rinaldi; Gianluca Franceschini; Lorenzo Bonomo Journal: Radiol Med Date: 2014-08-06 Impact factor: 3.469