Breast Intro

• Grading:
  • Nottingham (aka "modified (Scarff)-Bloom-Richardson" or "Elston-Ellis"):
    • Tubule formation:
      • 1 = >75%
      • 2 = 10% to 75%
      • 3 = <10%
    • Mitoses: per 10 HPF, varies by field size of particular lens
      • 1 = <7 (<5)
      • 2 = 7 to 14 (5 to 10)
      • 3 = >14 (>10)
    • Nuclear pleomorphism:
      • 1 = small, uniform
      • 2 = moderate increase in size & variation
      • 3 = marked variation
    • Grade 1 (3,4,5): Low grade; well differentiated
    • Grade 2 (6,7): Intermediate grade; moderately differentiated
    • Grade 3 (8,0): High grade; poorly differentiated

• Nottingham grade is a predictor of OVERALL survival per increase in one grade. (DFS also associated with grade in LN POSITIVE, but not LN NEGATIVE, patients.)