The importance of histologic grade in long-term prognosis of breast cancer: a study of 1,010 patients, uniformly treated at the Institut Gustave-Roussy.

Abstract

In a study of 1,010 patients with solitary, unilateral, nonmetastatic breast cancer, the histologic grade, assessed by a multifactorial analysis (Cox model) to study its significance with other prognostic factors, was found to be an important, independent factor. For 612 operable patients, two laboratory characteristics, the number of histologically positive nodes and the histologic grade, were the most valuable predictors. These two factors alone form a predictive index that may be an excellent and simple guide for the clinical decision of subsequent therapy. For 398 patients with inoperable breast cancer (ie, tumor greater than or equal to 7 cm, N2-3, inflammatory, skin fixation, and clinically rapidly growing forms), the histologic grade (performed on drill or cutting needle biopsy) was again a most important (and with inflammatory forms the most important) predictor of prognosis in these patients. Our data support that performing our modified histoprognostic grading of Scarff and Bloom is simple, reproducible, incurs no additional cost, may be carried out in the simplest histology laboratory, and finally, defines an important risk factor in all patients. It should be routine for all breast cancer specimens. Furthermore, studies of adjuvant therapy should stratify patients for this variable.

Morphometrical malignancy grading is a valuable prognostic factor in invasive ductal breast cancer

“…In the medical literature, there is abundant confirmation on the prognostic significance of the histological grading of invasive breast cancer (Davis et al, 1986;Contesso et al, 1987Contesso et al, , 1989Elston and Ellis, 1991;Aaltomaa et al, 1991;Simpson and Page, 1994;Roberti, 1997;Page et al, 1998). Grading has also been acknowledged to have additional prognostic value in small (51 cm in diameter) and axillary lymph node-negative tumours (Hopton et al, 1989;Stierer et al, 1992;Lee et al, 1996).…”

“…Histological malignancy grading of invasive ductal breast cancer provides valuable information of the outcome of the patient (Parl and Dupont 1982, Davis et al, 1986, Contesso et al, 1987, 1989Henson, 1988;Elston and Ellis, 1991;Simpson and Page, 1994;Roberti et al, 1997;Page et al, 1998). Standardised applications of the grading system have led to still higher accuracy in predicting the outcome of breast cancer (Theissig et al, 1990;Royal College of Pathologists Working Group, 1991;Elston and Ellis, 1991;Simpson and Page, 1994).…”

CXCR4 Expression in Early Breast Cancer and Risk of Distant Recurrence

“…The remaining 247 patients were premenopausal and presented with negative axillary nodes, but with tumor grade II or III. Tumor grade was defined according to a modified Scarff-Bloom-Richardson classification [14]. ER expression status was determined by ligand-binding assay (cutoff, 10 fmol/mg protein).…”

Breast‐conserving surgery after neoadjuvant anthracycline‐based chemotherapy for large breast tumors

“…The histologic grade was assessed using the Scarff, Bloom, and Richardson (SBR) method. 9 Three or four cycles of preoperative chemotherapy were administered at 21-day intervals or longer, depending on the bone marrow recovery. Four chemotherapy regimens were used: 206 patients (35%) received AVCMF (doxorubicin at a dose of 50 mg/m 2 , vincristine at a dose of 1 mg/m 2 , cyclophosphamide at a dose of 600 mg/m 2 , methotrexate at a dose of 30 mg/m 2 , and 5-fluorouracil at a dose of 900 mg/m 2 ), 22 (4%) and 170 (28%) patients received FAC 50/FEC 50 -60 (doxorubicin at a dose of 50 mg/m 2 , epirubicin at a dose of 50/60 mg/m 2 , cyclophosphamide at a dose of 600 mg/m 2 , and 5-FU at a dose of 900 mg/m 2 ), respectively, and 196 patients (33%) received FEC 100 (epirubicin at a dose of 100 mg/m 2 , cyclophosphamide at a dose of 1000 mg/m 2 , and 5-FU at a dose of 1000 mg/m 2 ).…”