Nottingham grade
A standardized histological grading system for invasive breast carcinoma based on tubule formation, nuclear pleomorphism, and mitotic count.
Full Definition
The Nottingham grading system, also known as the modified Bloom-Richardson grade or Elston-Ellis grade, is the standard method for histologically grading invasive breast carcinomas. The system evaluates three morphological features: degree of tubule/gland formation, nuclear pleomorphism, and mitotic count per high-power field. Each feature is scored from 1 to 3 points, and the total score (3-9 points) determines the final grade: Grade 1 (well-differentiated, 3-5 points), Grade 2 (moderately differentiated, 6-7 points), or Grade 3 (poorly differentiated, 8-9 points). Higher grades are associated with more aggressive tumor behavior, increased likelihood of metastasis, and poorer prognosis. This grading information is essential for treatment planning and is incorporated into various prognostic algorithms.
Usage
Usage note: Specify 'Nottingham grade' rather than generic 'tumor grade' for precision; sometimes abbreviated as NG in clinical notes.
In Context
- "Histopathology revealed invasive ductal carcinoma, Nottingham grade 2." — Pathology report
- "The Nottingham grade 3 tumor prompted discussion of aggressive adjuvant therapy." — Multidisciplinary team meeting