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How Breast Cancer is Graded

written by: Jim Vassallo • edited by: Diana Cooper • updated: 8/29/2010

Breast cancer is not the deadliest cancer around today but it is still serious. Grading breast cancer helps doctors determine how to treat the tumor(s).

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    As women get older, it is recommended that they have a mammogram every one to two years beginning at the age of 40, hoping to prevent or catch the onset of breast cancer before it is too late. Women who have been diagnosed with breast cancer are not always out of luck when it comes to recovery time. Most women who are diagnosed with breast cancer typically have a great chance of surviving the disease, even if it is caught in its late stages. When it comes to grading breast cancer, the Bloom-Richardson Grading System, is the most common system used by doctors and surgeons alike.

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    Bloom-Richardson Grading System

    800px-Breast cancer The Bloom-Richardson Grading System is used to grade the advancement of breast cancer. The system examines the cells of the breast tissue and the structure of the breast tissue to figure out how aggressive and invasive the cancer is in the body. The grading system tries to answer the following questions related to breast cancer:

    • How much of the tumor consists of normal duct structures?
    • When the pathologist uses a microscope, how many dividing cells (mitotic figures) does he see? The more dividing cells the pathologist sees through the microscope, the worse off the cancer actually is.
    • When examining the tumor, are the cell nuclei larger, irregular, and darker than normal epithelial cells?

    The three of these aspects of breast cancer are assigned a value ranging from 1 to 3. Then the scores are added together to determine a grade ranging from 3 to 9. Once this second value is determined, the Bloom-Richardson Grading System can be applied to the tumor found in the patient's chest. The grading system is as follows:

    • Value 3-5: Grade 1 tumor, which is considered well differentiated and is the best prognosis for the patient.
    • Value 6-7: Grade 2 tumor, which is considered moderately differentiated and is a medium prognosis.
    • Value 8-9: Grade 3 tumor, which is poorly differentiated and is the worst prognosis.

    The best survival rate for patients is a lower grade tumor, which can be treated with surgery that is less aggressive and combined with medication. A high graded tumor must be treated with a strongly aggressive form of surgery, radiation, and drugs that have strong adverse effects on the patient. A highly graded tumor, even with all of those treatment options, have a low survival rate.

    Image Credit: Wikimedia Commons http://commons.wikimedia.org/wiki/File:Breast_cancer.JPG

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    Preventing Breast Cancer

    The best way to prevent breast cancer is to receive a mammography every one to two years once you hit the age of 40. This is especially true should you have a family member with breast cancer, which means you might want to consider getting a mammography at a younger age. Grading breast cancer is an important part of the treatment process because it tells doctors what types of treatments are needed.

    References:

    http://www.cancer.gov/cancertopics/factsheet/Detection/tumor-grade

    http://www.ccrcal.org/Vol_1/BloomRichardsonGradeForBreastCancer_CA.htm