Pathologic grading is based on Modified Bloom Richardson scoring which utilizes three variables: gland-formation (tubularity), degree of variation in nuclear size and shape (pleomorphism), and ‘hyper chromatic figures’ as an estimate of proliferation(Bloom HJG et al 1957 and S. THORESENet al1982). The College of American Pathologists and the World Health Organization endorse this classification. The basic principle is summation of scores for the three variables, each of which is assigned from one to three points according to degree of departure from normal breast epithelium. A total score of 5 or less defines grade 1, 6–7 points grade 2 and 8–9 points grade 3.( Spitale, A. Et al 2009) The management of breast cancer has evolved over the years with multimodality therapy becoming commonplace. These recent advances in breast cancer treatment have required better characterization of the different prognostic and histologic subgroups. Targeted systemic therapy is a goal and better understanding of these differences is essential to direct and individualize treatment decisions(Arps DP, 2013). Current and emerging biomarkers in breast cancer: prognosis and prediction …show more content…
Clinical parameters such as tumor size, state of the lymph nodes, and others, have been used as prognostic factors in breast cancer. However, it has been necessary to establish additional factors in order to classify patients according to indicators such as the recurrence risk and the type of therapy to administer. Interest in novel prognostic markers is based on the fact that a significant number of patients with early stage breast cancer harbor microscopic metastasis at the time of diagnosis (Buyse M, et al