System

• The Scarff-Bloom-Richardson (SBR) system was used exclusively to grade breast cancer tumors for many years. Pathologists are now using other types of grading for breast cancer. These include the Elston-Ellis and Black method. The Nottingham grading is yet another slightly modified version of SBR. All of these are histological tumor grade systems.
  
  

Significance

• When a tumor is graded, the cancer cells are classified to make a determination of their abnormalities and how quickly it is likely to spread. The grading used for breast cancer is a bit different from that used for other tumors. It is used in conjunction with staging of the cancer (how far it has spread) to determine the best course of treatment.
  
  

Grades

• Breast cancer tumors are graded on a scale of 1 to 3, with 1 as the least severe. In Grade 1 is considered well differentiated, with cells that are not growing quickly. Grade 2 is moderately differentiated, growing a bit faster. A Grade 3 indicates that the cells are poorly differentiated. A Grade 3 cancer cell looks abnormal and is more likely to spread and grow rapidly.
  
  

Use

• SBR breast cancer tumor grading and its modifications are used for cancers that are invasive, not in situ cancer. For ductal carcinoma in situ (called "DCIS"), a nuclear grade is sometimes given. This type of grading will indicate the areas of cancer cells that are degenerating as in an aggressive cancer. It also is more accurate in its description of the abnormal cancer cells. Nuclear grading is also used to define cancers like DCIS that are more likely to return.
  
  

Considerations

• Though there are different grading methods used, they all use the same principle with the objective to define the growth of the cancer cells. When pathologists are grading tumors, they also look at the surrounding tissue (and lymph nodes) to complete the process. If high grades are found in the tumor and nearby tissue, the cancer will be staged higher and considered more aggressive