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The Nottingham prognostic index (NPI) is used to determine prognosis following surgery for breast cancer. [1] [2] Its value is calculated using three pathological criteria: the size of the tumour; the number of involved lymph nodes; and the grade of the tumour. [1] It is calculated to select patients for adjuvant treatment.
The Nottingham system is also called the Bloom–Richardson–Elston system (BRE), [14] or the Elston-Ellis modification [15] of the Scarff-Bloom-Richardson grading system. [ 16 ] [ 17 ] It grades breast carcinomas by adding up scores for tubule formation , nuclear pleomorphism , and mitotic count , each of which is given 1 to 3 points.
The neoplastic grading is a measure of cell anaplasia (reversion of differentiation) in the sampled tumor and is based on the resemblance of the tumor to the tissue of origin. [1] Grading in cancer is distinguished from staging , which is a measure of the extent to which the cancer has spread .
A Seer study of 750 individuals with pure or mixed ICCB reported that: a) 92.8% consisted of tumor cells that were scored well-differentiated (i.e. grade 1) or moderately well-differentiated (grade 2) (differentiation is the degree to which tumor cells resemble the non-cancerous cells in the tissue from which they derived) while 7.2% were ...
Another study showed “90% of recurrences occurred within 9, 7, and 5 years for patients with grades 1, 2, and 3 tumors, respectively. The rate of death due to breast carcinoma was also influenced by grade, with 90% occurring in 40, 13, and 8 years among patients with grades 1, 2, and 3 tumors, respectively.” [12] [30]
Delayed presentation with recurrent low-grade urothelial carcinoma is an unusual entity and potential mechanism of traumatic implantation should be considered. Characteristically low-grade tumors are resistant to systemic chemotherapy and curative-intent surgical resection of the tumor should be considered. [citation needed]
A pragmatic approach would be to recommend radical therapy only for extensive pure IDCP that is morphologically unequivocal for high-grade prostate cancer. [20] Active surveillance is not appropriate when low-grade invasive cancer is associated with IDCP, as such patients usually have unsampled high-grade prostatic adenocarcinoma. [20]
Nowadays, PIN 1 is referred to as low grade PIN, and PIN 2 and PIN 3 are grouped together as high grade PIN. [10] Only high grade PIN has been shown to be a risk factor for prostate cancer. Because low grade PIN has no significance and does not require repeat biopsies or treatment, it is not mentioned in pathology reports. As such, PIN has ...