In early-stage breast cancer, where the use of systemic therapy has to be determined for every patient, the three main prognostic determinants used in routine practice are lymph node (LN) status, tumor size, and histological grade. Management of breast cancer relies on the availability of robust clinical and pathological prognostic and predictive factors to guide patient decision making and the selection of treatment options. Here, we present an analysis of the validity of histological grade as a prognostic factor and a consensus view on the significance of histological grade and its role in breast cancer classification and staging systems in this era of emerging clinical use of molecular classifiers.īreast cancer is the most common cancer in women and a leading cause of cancer death worldwide. It is essential that they provide additional prognostic or predictive information above and beyond that offered by current parameters. Clinical acceptance of these molecular assays will require them to be more than expensive surrogates of established traditional factors such as histological grade. Also, expression profiling studies have generated clinically useful data that have significantly improved our understanding of the biology of breast cancer, and these studies are undergoing evaluation as improved prognostic and predictive tools in clinical practice. Genome-wide microarray-based expression profiling studies have unraveled several characteristics of breast cancer biology and have provided further evidence that the biological features captured by histological grade are important in determining tumor behavior. One of the best-established prognostic factors in breast cancer is histological grade, which represents the morphological assessment of tumor biological characteristics and has been shown to be able to generate important information related to the clinical behavior of breast cancers. Current routine clinical management of breast cancer relies on the availability of robust clinical and pathological prognostic and predictive factors to support clinical and patient decision making in which potentially suitable treatment options are increasingly available. Breast cancer is a heterogeneous disease with varied morphological appearances, molecular features, behavior, and response to therapy.
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