Evaluation of tumor aggressiveness in breast carcinoma according to a scoring method

A scoring system was used to classify 310 patients with breast carcinoma. Tumors were divided and scored according to their architectural patterns and histological features of known prognostic significance such as tumor volume, nuclear grade, mitosis, etc. According to the scoring value, tumors were classified as aggressive (A), moderately aggressive (M), and low aggressive (L). Results showed a higher rate of metastasis in patients with A tumors (72%) and M tumors (63%) when compared with L tumors (22%). There were 175 patients with axillary lymph node metastasis. Of these, 101 had A tumors, 91 had recurrences (90%), and 81 died (80%); of the 56 patients with M tumors, 26 had recurrences (46%) and 9 died (16%) (P less than 0.001). None of the 18 cases classified as L recurred (P less than 0.001). There were 135 patients with no nodal metastasis: 39 had A tumors (21 recurrences [54%] and 19 deaths [49%] and 96 had M and L tumors (1 recurrence [1%] and no deaths) (P less than 0.001).