The prognostic factors in breast cancer are tumor stage, type, grade, hormonal receptor, tumor proliferative fraction, oncogene, altered growth factor receptor and angiogenesis. Since the first systematic study on grading system of breast cancer
was
published by Greenhough in 1925, a number of grading systems including Bloom-Richardson's histologic method and Black's nuclear method have been reported and used. These grading systems have been considered as a classic and important prognostic
factor
for long time. In spite of this fact, there is a growing tendency that pathologists and clinicians disagree with grading system due to different results for prognosis and lack of reproducibility. Although these earlier analyses indicated that
Bloom
Richardson's grade is prognostically more significant than Black's grade, subsequent analysis indicate the converse.
To investigate and evaluate usefulness of Bloom-Richardson grade and Black's grade, we examined the correlation of two grading systems and other established prognostic factors, (i.e, tumor size, status of estrogen receptor, c-erbB-2 oncoprotein,
Ki-67
labelling index, axillary modal metastasis and microvessel count), in 62 cases of infiltrative ductal carcinoma of the breast.
1) Bloom-Richardson's histologic grade had significant correlation in nuclear grade, status of estrogen receptor, and Ki 67 labelling index. Tumor size and c-erbB-2 oncoprotein were also correlated with histologic grade, but it was statistically
insignificant.
2) Black's nuclear grade had also significant correlation in histologic grade, status of estrogen receptor, c-erbB-2 oncoprotein and Ki 67 labelling index. Tumor size and axillary node metastasis were correlated, but they were statistically
insignificant.
3) Metastasis and angiogenesis were not correlated with tumor grade.
We could not compare histologic grade with nuclear grade fundamentally, because we failed to pursue patient's survival rate. However tumor grade in breast carcinoma served as a mandatory factor to get insights for status of other established
prognostic
factors or further prediction of patient's prognosis.
|