Histologic classification of IDC is based on grading, which is of high clinical relevance for predicting the prognosis of the patient and when assessing the need for post-surgical adjuvant therapies.
Several grading schemes have been presented, of which the Bloom-Richardson and the Elston-Ellis modification are the most commonly used.
Grading is based on assessing: 1. The degree of tubule and glandular structure formation (present in <10%, 10-75%, or >75% of the tumor; giving scores 3,2 or 1), 2. Nuclear pleomorphism (small regular uniform cells =1; moderate increase in size and variability =2 ; and marked variation =3) 3. Mitotic count (per 10 high power fields). The cutoffs for 1, 2, and 3 grade points depend on the area of the microscope field.
Histologic grade = 1 if the sum of the scores is 5 or less, grade = 2 if the sum is 6-7 and grade = 3 if the sum is 8 or 9.
Grade 1
Grade 2
Grade 3
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