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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
This system uses a grading score ranging from 2 to 10. Lower Gleason scores describe well-differentiated less aggressive tumors. Other systems include the Bloom-Richardson grading system for breast cancer and the Fuhrman system for kidney cancer. Invasive-front grading is useful as well in oral squamous cell carcinoma. [4]
The histologic appearance of cancer cells can be scored on these three parameters on a scale from one to three. The sum of these grades is a number between 3 and 9. The score is called a Bloom Richardson Grade (BR) and is expressed [sum of the grades]/9. For example, cells that were graded 2 on all three parameters would result in a BR score of ...
M describes distant metastasis (spread of cancer from one part of the body to another). The TNM staging system for all solid tumors was devised by Pierre Denoix of the Institut Gustave Roussy between 1943 and 1952, using the size and extension of the primary tumor, its lymphatic involvement, and the presence of metastases to classify the ...
Surgical margin in a surgery report defines the visible margin or free edge of "normal" tissue seen by the surgeon with the naked eye. Surgical margin as read in a pathology report defines the histological measurement of normal or unaffected tissue surrounding the visible tumor under a microscope on a glass mounted histology section.
If the neoplasm has only one pattern, the grade of that pattern is doubled to obtain the score. For example, if a tumor is entirely grade 1, the Gleason score would be 1+1=2. The most differentiated tumor would have the lowest score, Gleason 2 (1+1), while the most undifferentiated neoplasm (not resembling native prostate tissue) would have the ...
This tissue is sent for pathology testing to assign a histologic classification that is more definitive than a Pap smear result (which is a cytologic finding). HSIL generally corresponds to the histological classification of CIN 2 or 3. [citation needed] HSIL treatment involves the removal or destruction of the affected cells, usually by LEEP.