Histological grade and other prognostic factors in relation to survival of patients with breast cancer

Freedman, Laurence S.; Edwards, D; McConnell, E. M.; Downham, D. Y.

doi:10.1038/bjc.1979.139

Cited by 74 publications

(32 citation statements)

References 10 publications

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“…The 5-year survival (Table I) decreased steadily with both increasing stage (Langlands & Kerr, 1978) and grade (Freedman et al, 1979). Tumour size increased with increasing grade (I, 2*4cm+ 1 4; II, 3 0 cm+ 1-4; JII,3A4 cm+ 1.6) in keeping with Fisher et al (1980).…”

supporting

confidence: 81%

Histological grading and clinical stage at presentation in breast carcinoma

Sø¹

1982

Br J Cancer

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supporting

confidence: 81%

Histological grading and clinical stage at presentation in breast carcinoma

Sø¹

1982

Br J Cancer

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“…6 Histologic grade is strongly correlated with prognosis, and is correlated with both disease-free and overall survival. [20][21][22][23] The authors of the original study stressed that this grading system had clinical utility for both invasive lobular carcinoma and special type cancers. This was further validated by the work of Sastre-Garau et al, 24 who showed that histologic grade is as important for prognosis in invasive lobular carcinoma as it is in invasive ductal carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Invasive lobular carcinoma: to grade or not to grade

et al. 2005

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Grading of invasive ductal carcinoma of no special type using the Nottingham combined histologic grading system provides independent prognostic information. The prognostic utility of grading invasive lobular carcinomas, however, has not been fully elucidated. In addition, the relationship between grade in invasive lobular carcinomas and expression of predictive biomarkers is less certain. The purpose of this study was to correlate histologic grade in invasive lobular carcinoma with known prognostic and predictive markers. All primary resections for invasive mammary carcinomas diagnosed in Mount Sinai Hospital, Toronto, between the years 1996 and 2002 were reviewed (n ¼ 1053). Of these cases, 50 were pure invasive lobular carcinoma (incidence 4.7%). The median age at diagnosis was 64 years. These tumors were graded using the Nottingham combined histologic grading system and analyzed for estrogen receptor, progesterone receptor, HER2/neu and E-cadherin expression. Tumor grade was correlated with tumor size (P ¼ 0.03), and the American Joint Committee on Cancer nodal status (P ¼ 0.05). Assessment of the individual components of grade showed that the mitotic score was highly correlated with tumor size (P ¼ 0.02), lymph node positivity (P ¼ 0.02) and overall American Joint Committee on Cancer stage (P ¼ 0.01). Estrogen receptor and progesterone receptor were highly expressed irrespective of the grade of tumor. HER2/neu protein overexpression and E-cadherin protein expression was absent in all invasive lobular carcinomas studied. We conclude that pure invasive lobular carcinoma is uncommon and occurs predominantly in postmenopausal women. Increasing tumor grade is correlated with median tumor size and the American Joint Committee on Cancer nodal stage, but not correlated with the expression of estrogen receptor, progesterone receptor, E-cadherin or HER2/neu protein overexpression.

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“…Nuclear hyperchromatism and mitosis is the factor of importance to grading in this respect. This factor also differentiated between RE+ and RE-carcinomas in this material.PROGNOSIS IN BREAST CARCINOMA iS related to the histological grade of the primary tumour (Freedman et al, 1979). The TNM stage (International Union against Cancer, 1972) at which a tumour presents is also a reflection of its histological grade (Thoresen et al, 1981).…”

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Histological grade and efferent vascular invasion in human breast carcinoma

Hartveit¹,

Sø²,

Thorsen³

et al. 1981

Br J Cancer

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Summary.-Primary breast carcinomas (23) with axillary-node metastases that also showed tumour cells in the efferent nodal vessels, tended to be of higher histological grade than those (21) without efferent vascular invasion. Nuclear hyperchromatism and mitosis is the factor of importance to grading in this respect. This factor also differentiated between RE+ and RE-carcinomas in this material.PROGNOSIS IN BREAST CARCINOMA iS related to the histological grade of the primary tumour (Freedman et al., 1979). The TNM stage (International Union against Cancer, 1972) at which a tumour presents is also a reflection of its histological grade (Thoresen et al., 1981). Prognosis is further clearly related to the presence or absence of nodal metastases (Truscott, 1947) and patients who in addition to nodal tumour have tumour cells in their efferent nodal vessels (efferent vascular invasion (EVI), Hartveit, 1979b) have a poorer 5-year survival than those without (Hartveit, 1979a).The relationship between histological grade and EVI has now been investigated in a series of 44 patients, 23 with and 21 without EVI. PATIENTS, MATERIAL AND METHODSThe patients investigated formed part of a series of 222 cases that has been reported in connection w\ith histological grading and oestrogen receptor (RE) status of the primary (Thoresen et al., 1981). The relationship between RE status, EVI and early recurrence in this material has also been reported (Hartveit et al., 1980a, b).The present series consists of consecutive cases of primary infiltrating breast carcinoma in which modified radical mastectomy and axillary-node dissection had been carried out. Cases were excluded if the tumour type was not suitable for grading by the WHO method (Scarff & Torloni, 1968) or if the nodal sections available did not pass through the efferent area at the hilus (Hartveit, 1979b).A total of 44 cases were available for study, 23 with EVI and 21 without. Of the former 18 were RE+ (> 3 fmol receptor per mg cytosol protein); 15 of the EVI-were also RE+. In the material as a whole there was little difference in RE status according to TNM stage on a percentage basis (Table I), or nodal metastases (Table II). The excess of RE+ tumours in these 2 subgroups is thus probably a function of the composition of the material as a whole.The histological grade of the primary tumours in each subgroup had been recorded previously. These records were reviewed and the results broken up into their separate factors. In addition to the histological grade, the number of points scored for the 3 factors used (i.e. tubular formation, 1-3; nuclear hyperchromatism and mitosis, 1-3; and nuclear pleiomorphism, 1-3; see Scarff & Torloni, 1968) were noted and the mean values calculated. A similar procedure was followed for the nodal tumour which had not been graded before.The mean number of points scored was also related to the RE status of the primary tumour, using the dextran-coated charcoal

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Histological grade and other prognostic factors in relation to survival of patients with breast cancer

Cited by 74 publications

References 10 publications

Histological grading and clinical stage at presentation in breast carcinoma

Histological grading and clinical stage at presentation in breast carcinoma

Invasive lobular carcinoma: to grade or not to grade

Histological grade and efferent vascular invasion in human breast carcinoma

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