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For example, if the primary tumor grade was 2 and the secondary tumor grade was 3 but some cells were found to be grade 4, the Gleason score would be 2+4=6. This is a slight change from the pre-2005 Gleason system where the second number was the secondary grade (i.e., the grade of the second-most common cell line pattern).
There are several reasons why PIN is the most likely prostate cancer precursor. [3] PIN is more common in men with prostate cancer. High grade PIN can be found in 85 to 100% of radical prostatectomy specimens, [4] nearby or even in connection with prostate cancer. It tends to occur in the peripheral zone of the prostate.
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]
Grading in cancer is distinguished from staging, which is a measure of the extent to which the cancer has spread. Pathology grading systems classify the microscopic cell appearance abnormality and deviations in their rate of growth with the goal of predicting developments at tissue level (see also the 4 major histological changes in dysplasia ).
In 2023, the number of prostate cancer cases rose to 55,033, while breast cancer diagnoses decreased to 47,526. The data also indicates a 25% rise in prostate cancer cases between 2019 and 2023.
Prostate cancer is the most diagnosed cancer in men in over half of the world's countries, and the leading cause of cancer death in men in around a quarter of countries. [ 91 ] Prostate cancer is rare in those under 40 years old, [ 92 ] and most cases occur in those over 60 years, [ 2 ] with the average person diagnosed at 67. [ 93 ]
Recognizing that these men differ from those diagnosed today with PSA screening, the cumulative incidence of death from prostate cancer was 20.7% in the untreated group overall, and 11% for men with low risk disease (PSA below 10 ng/ml and Gleason score below 7) - similar to the cumulative incidence of death from prostate cancer of 12.3% at 30 ...
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