Histological grading of invasive breast carcinoma - a simplification of existing methods in a large conservation series with long-term follow-up
Aims: To assess the validity of grading in the Edinburgh Breast Conservation Series; a consecutive cohort of 1812 early breast cancer patients treated by breast conservation and radiotherapy between 1981 and 1998 in a single specialist centre with ≥9 years’ follow‐up and full staging data. Methods...
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| Veröffentlicht in: | Histopathology 2009-12, Vol.55 (6), p.724-731 |
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| container_title | Histopathology |
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| creator | Thomas, Jeremy St J Kerr, Gillian R Jack, Wilma J L Campbell, Fiona McKay, Laura Pedersen, Hans-Christian Kunkler, Ian H Cameron, David A Chetty, Udi Bartlett, John M S |
| description | Aims: To assess the validity of grading in the Edinburgh Breast Conservation Series; a consecutive cohort of 1812 early breast cancer patients treated by breast conservation and radiotherapy between 1981 and 1998 in a single specialist centre with ≥9 years’ follow‐up and full staging data.
Methods and results: A single pathologist (J.St.J.T) graded 1650 cases using the Elston and Ellis method (EE) with particular reference to the component data: acinar differentiation, nuclear pleomorphism and mitotic counts. The original method was then compared with binary scoring of the same components and the relationship to prognosis reassessed. EE grades and individual grade components were prognostic (P |
| doi_str_mv | 10.1111/j.1365-2559.2009.03429.x |
| format | Article |
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Methods and results: A single pathologist (J.St.J.T) graded 1650 cases using the Elston and Ellis method (EE) with particular reference to the component data: acinar differentiation, nuclear pleomorphism and mitotic counts. The original method was then compared with binary scoring of the same components and the relationship to prognosis reassessed. EE grades and individual grade components were prognostic (P < 0.0001) with 10‐year cause‐specific survival of 95.6%, 86.4% and 74.7% for EE grades 1, 2 and 3, respectively. A binary scoring of grade components produces four groups, splitting EE grade 2 tumours into two groups with different outcomes – 10‐year survival rates for the four revised grades were 96.0%, 89.0%, 79.7% and 75.4%, respectively.
Conclusions: Existing grading methodology is fully applicable in the narrower context of a conservation series but can be simplified. Subdivision of EE grade 2 into a true intermediate prognosis group and a second group with a worse prognosis also adds benefit.</description><identifier>ISSN: 0309-0167</identifier><identifier>EISSN: 1365-2559</identifier><identifier>DOI: 10.1111/j.1365-2559.2009.03429.x</identifier><identifier>PMID: 19845790</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; breast cancer ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Female ; grading ; Gynecology. Andrology. Obstetrics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Lymphatic Metastasis ; Mammary gland diseases ; Medical sciences ; Mitosis ; Neoplasm Staging ; outcomes ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Prognosis ; Severity of Illness Index ; Survival Rate ; Tumors</subject><ispartof>Histopathology, 2009-12, Vol.55 (6), p.724-731</ispartof><rights>2009 The Authors. Journal compilation © 2009 Blackwell Publishing Limited</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4369-f8758b148415f04c1cd0c2c7e229b835d0fe887d528d2609b71dc81b5f83725c3</citedby><cites>FETCH-LOGICAL-c4369-f8758b148415f04c1cd0c2c7e229b835d0fe887d528d2609b71dc81b5f83725c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2559.2009.03429.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2559.2009.03429.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22195080$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19845790$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thomas, Jeremy St J</creatorcontrib><creatorcontrib>Kerr, Gillian R</creatorcontrib><creatorcontrib>Jack, Wilma J L</creatorcontrib><creatorcontrib>Campbell, Fiona</creatorcontrib><creatorcontrib>McKay, Laura</creatorcontrib><creatorcontrib>Pedersen, Hans-Christian</creatorcontrib><creatorcontrib>Kunkler, Ian H</creatorcontrib><creatorcontrib>Cameron, David A</creatorcontrib><creatorcontrib>Chetty, Udi</creatorcontrib><creatorcontrib>Bartlett, John M S</creatorcontrib><title>Histological grading of invasive breast carcinoma - a simplification of existing methods in a large conservation series with long-term follow-up</title><title>Histopathology</title><addtitle>Histopathology</addtitle><description>Aims: To assess the validity of grading in the Edinburgh Breast Conservation Series; a consecutive cohort of 1812 early breast cancer patients treated by breast conservation and radiotherapy between 1981 and 1998 in a single specialist centre with ≥9 years’ follow‐up and full staging data.
Methods and results: A single pathologist (J.St.J.T) graded 1650 cases using the Elston and Ellis method (EE) with particular reference to the component data: acinar differentiation, nuclear pleomorphism and mitotic counts. The original method was then compared with binary scoring of the same components and the relationship to prognosis reassessed. EE grades and individual grade components were prognostic (P < 0.0001) with 10‐year cause‐specific survival of 95.6%, 86.4% and 74.7% for EE grades 1, 2 and 3, respectively. A binary scoring of grade components produces four groups, splitting EE grade 2 tumours into two groups with different outcomes – 10‐year survival rates for the four revised grades were 96.0%, 89.0%, 79.7% and 75.4%, respectively.
Conclusions: Existing grading methodology is fully applicable in the narrower context of a conservation series but can be simplified. Subdivision of EE grade 2 into a true intermediate prognosis group and a second group with a worse prognosis also adds benefit.</description><subject>Biological and medical sciences</subject><subject>breast cancer</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Female</subject><subject>grading</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Lymphatic Metastasis</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Mitosis</subject><subject>Neoplasm Staging</subject><subject>outcomes</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Prognosis</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><subject>Tumors</subject><issn>0309-0167</issn><issn>1365-2559</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkctu1DAUhiMEokPhFZA3iFWCL3FsL1igCjoVVZGYIiQ2luPYUw9OPNiZS9-CR8Yho2GLNz6Sv-8c6_xFARCsUD7vNhUiDS0xpaLCEIoKkhqL6vikWJwfnhYLSKAoIWrYRfEipQ2EiBGMnxcXSPCaMgEXxe-lS2PwYe208mAdVeeGNQgWuGGvktsb0Eaj0gi0itoNoVegBAok12-9s1kaXRgm3hxzo8ntzfgQupQbZM6ruDZAhyGZuJ_ZXDmTwMGND8CHYV2OJvbABu_DodxtXxbPrPLJvDrdl8W3Tx_vr5bl7Zfrm6sPt6WuSSNKyxnlLap5jaiFtUa6gxprZjAWLSe0g9ZwzjqKeYcbKFqGOs1RSy0nDFNNLou3c99tDL92Jo2yd0kb79Vgwi5JRmok6pqwTPKZ1DGkFI2V2-h6FR8lgnKKQ27ktHU5bV1Occi_cchjVl-fhuza3nT_xNP-M_DmBKiUA7BRDdqlM4cxEhTyiXs_cwfnzeN_f0Aub1ZTlf1y9nNI5nj2VfwpG0YYld_vriVarb7e_7j7LDn5A1E7t2U</recordid><startdate>200912</startdate><enddate>200912</enddate><creator>Thomas, Jeremy St J</creator><creator>Kerr, Gillian R</creator><creator>Jack, Wilma J L</creator><creator>Campbell, Fiona</creator><creator>McKay, Laura</creator><creator>Pedersen, Hans-Christian</creator><creator>Kunkler, Ian H</creator><creator>Cameron, David A</creator><creator>Chetty, Udi</creator><creator>Bartlett, John M S</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200912</creationdate><title>Histological grading of invasive breast carcinoma - a simplification of existing methods in a large conservation series with long-term follow-up</title><author>Thomas, Jeremy St J ; Kerr, Gillian R ; Jack, Wilma J L ; Campbell, Fiona ; McKay, Laura ; Pedersen, Hans-Christian ; Kunkler, Ian H ; Cameron, David A ; Chetty, Udi ; Bartlett, John M S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4369-f8758b148415f04c1cd0c2c7e229b835d0fe887d528d2609b71dc81b5f83725c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Biological and medical sciences</topic><topic>breast cancer</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Female</topic><topic>grading</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Lymphatic Metastasis</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Mitosis</topic><topic>Neoplasm Staging</topic><topic>outcomes</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Prognosis</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Jeremy St J</creatorcontrib><creatorcontrib>Kerr, Gillian R</creatorcontrib><creatorcontrib>Jack, Wilma J L</creatorcontrib><creatorcontrib>Campbell, Fiona</creatorcontrib><creatorcontrib>McKay, Laura</creatorcontrib><creatorcontrib>Pedersen, Hans-Christian</creatorcontrib><creatorcontrib>Kunkler, Ian H</creatorcontrib><creatorcontrib>Cameron, David A</creatorcontrib><creatorcontrib>Chetty, Udi</creatorcontrib><creatorcontrib>Bartlett, John M S</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Histopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Jeremy St J</au><au>Kerr, Gillian R</au><au>Jack, Wilma J L</au><au>Campbell, Fiona</au><au>McKay, Laura</au><au>Pedersen, Hans-Christian</au><au>Kunkler, Ian H</au><au>Cameron, David A</au><au>Chetty, Udi</au><au>Bartlett, John M S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Histological grading of invasive breast carcinoma - a simplification of existing methods in a large conservation series with long-term follow-up</atitle><jtitle>Histopathology</jtitle><addtitle>Histopathology</addtitle><date>2009-12</date><risdate>2009</risdate><volume>55</volume><issue>6</issue><spage>724</spage><epage>731</epage><pages>724-731</pages><issn>0309-0167</issn><eissn>1365-2559</eissn><abstract>Aims: To assess the validity of grading in the Edinburgh Breast Conservation Series; a consecutive cohort of 1812 early breast cancer patients treated by breast conservation and radiotherapy between 1981 and 1998 in a single specialist centre with ≥9 years’ follow‐up and full staging data.
Methods and results: A single pathologist (J.St.J.T) graded 1650 cases using the Elston and Ellis method (EE) with particular reference to the component data: acinar differentiation, nuclear pleomorphism and mitotic counts. The original method was then compared with binary scoring of the same components and the relationship to prognosis reassessed. EE grades and individual grade components were prognostic (P < 0.0001) with 10‐year cause‐specific survival of 95.6%, 86.4% and 74.7% for EE grades 1, 2 and 3, respectively. A binary scoring of grade components produces four groups, splitting EE grade 2 tumours into two groups with different outcomes – 10‐year survival rates for the four revised grades were 96.0%, 89.0%, 79.7% and 75.4%, respectively.
Conclusions: Existing grading methodology is fully applicable in the narrower context of a conservation series but can be simplified. Subdivision of EE grade 2 into a true intermediate prognosis group and a second group with a worse prognosis also adds benefit.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19845790</pmid><doi>10.1111/j.1365-2559.2009.03429.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Biological and medical sciences breast cancer Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Female grading Gynecology. Andrology. Obstetrics Humans Investigative techniques, diagnostic techniques (general aspects) Lymphatic Metastasis Mammary gland diseases Medical sciences Mitosis Neoplasm Staging outcomes Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Prognosis Severity of Illness Index Survival Rate Tumors |
| title | Histological grading of invasive breast carcinoma - a simplification of existing methods in a large conservation series with long-term follow-up |
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