Grading

[Hilde 4]

Guten Tag, können Sie mir sagen, was bei Brustkrebs, \"optimiertes histologisches Grading nach Tawik) bedeutet? Wie geht so eine Optimierung von statten und warum wird das gemacht?

[Prof. Wust]

RE: Grading


Ich vermute, damit ist eine etwas genauere Ermittlung der prognostischen Faktoren mittels Hormonrezeptoren und anderen Markern gemeint. Dazu eine Arbeit. Der Herr heisst übrigens Tawfik. Bin mir aber nicht sicher. Es gibt jedenfalls einige Ansätze, zusätzliche Informationen aus der Histologie zu gewinnen.

A comparison of prognostic Tumor markers obtained on image-guided breast biopsies and final surgical specimens.
Connor CS, Tawfik OW, Joyce AJ, Davis MK, Mayo MS, Jewell WR.
Department of Surgery, University of Kansas Medical Center, Kansas City 66160, USA. [email protected]
BACKGROUND: This study was initiated to determine whether tumor markers obtained on image-guided breast biopsy specimens provide accurate prognostic information for women with invasive breast cancer. METHODS: Prognostic tumor markers on preoperative image-guided biopsy and final surgical specimens were compared in 44 patients with invasive breast cancer. RESULTS: Progesterone receptor (PR) discordance was 18%. In 87% of PR discordant cases, the image-guided biopsy was positive and the final specimen was negative (P = 0.03). Tumor grade was discordant in 36% of patients Discordance for estrogen receptor (ER) = 2%; MIB-1 = 18%; Her2/neu = 9%; EGFR = 10%; p53 = 9%; and bcl-2 = 0%. The discordance for these markers was random and did not reach statistical significance. CONC-LUSION: Image-guided core needle biopsies provide reliable information for the majority of prognostic tumor makers. A positive progesterone receptor is significantly more likely to be determined by core biopsy rather than the final surgical specimen. Tumor grade should be based upon the final surgical specimen whenever possible.