The grading of breast cancer tumors is done a bit differently than that in other cancers. The Scarff-Bloom-Richardson (SBR) system has been the most widely used by pathologists. Over the years pathologists have modified SBR grading a bit. The Elston-Ellis, Black and Nottingham grade systems have the same basic principles as SBR to assign grades to breast cancer tumors. Regardless of the exact method used, breast cancer tumors are graded with a score from one to three.
Procedure
If breast cancer is suspected, a biopsy is done to collect tissue samples. The samples are placed under a microscope to determine if cancer cells are present. If a malignancy (cancer) is determined, it is then decided the type of breast cancer. Before the cancer can be staged to see how far along it is the tumor must be graded. The pathologists combine the nuclear grade, mitotic rate and tubule formation to grade breast cancer.
Grade One
Grade one cells look fairly normal with a tubule format of greater than 75 percent. The cell division (mitosis) will be up to seven. Grade one cancer cells are small and they look fairly uniformed. Cells from breast cancer tumors at this stage are not growing at a rapid rate.
Grade Two
Grade two is less defined and more a combination of features that don't fit one and three, but instead fall between them. Grade two has moderately-differentiated cells. The tubule format is between 10 to 75 percent. There is some change is the size of the cells and variation. Cell division (mitosis count) is between eight and 14.
Grade Three
Grade three is the least differentiated and most aggressive of the breast cancer tumors. The features are not normal and are likely to spread and grow quickly. The tubule formation in grade three is less than 10 percent. There is a marked variation in the changing of the cells. There will also be a notable cell division (15 or more) in grade three tumors.
Consideration
A tumor grade is most significant for patients whose cancer has not spread to the lymph nodes. It is also not as accurate for DCIS (ductal carcinoma in situ), where a nuclear grade may be given instead to describe the abnormality of the cells. In combination of the grading of breast cancer tumors is the staging of the breast cancer itself. The staging tells how far the cancer has spread in the body.
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