Histologic Malignancy Grading of the Primary Tumour as a Prognostic Factor in Breast Cancer

Abstract

The prognostic value of the histologic malignancy grading system of Eker et al. (1) has been analysed in a prospective clinical study of 864 female breast cancer patients undergoing radical mastectomy. The percentage of patients with tumour infiltration of the axillary nodes was found to increase with increasing malignancy grade of the primary tumour (9% in grade I, 80% in grade IV). When the axillary nodes were not infiltrated, the recurrence rate was low, regardless of the malignancy grade. When the axillary nodes were infiltrated, the recurrence rate increased with increasing malignancy grade, from 34% in grades I and II up to 67% in grade IV. If the infiltration of the axillary nodes had not been known, the histologic grading of the primary tumour alone would have divided the case material into four prognostic groups with a recurrence rate increasing from 12.5% to 53.3%. In those cases where recurrences developed, however, the speed of progression of the disease did not seem to be related to the malignancy grade of the primary tumour.

Key Words:

• Breast cancer
• histologic malignancy grade
• prognosis