Using the Nottinghan score for tubular differentiation, a tubule Score 1: >75% of tumor area forming glandular/tubular structures, Score 2: 10% to 75% of tumor area forming glandular/tubular structures and Score 3:
Dear Rowen,
The cribriform pattern formation seen in cases of breast ca is seen inside the acini. In other words the acini are converted into cribriform pattern. both the ways the tubule is altered, hence what i think it should not be considered a good tubule and not counted in tubule formation in Nottingham score....!!
P.S: Thaz y a cribriform pattern of CA Breast is considered to be of a higher grade.
Thank you very much sir for your kind opinion. So in other words, would you designate a histologic score of 2 or 3 then? Thank you again
well, if it is transformed into a complete cribriform pattern, dont count it as a tubule...?? accordingly u can count the %age of tubules...!!
Very interesting question, and even more interesting answer. I am pathologist for almost 20 years, with special interest in breast pathology, and I have never thought about this part of Elston Ellis index in a such way. I have just checked Elston/Ellis book, and in the part about assessment of histological grade they use the term tubule formation without any additional information about possible variations. In my opinion, this is only semantic problem. I really do not think that cribriform structures, which are essentially composed of the multiple tubules, should be scored more than score 1. Otherwise cribriform carcinoma, which I always score as a grade 1 cancer (tubule formation score 1), would have never been prognostically favorable subtype of breast NST cancer.
Thank you Dr. Joško Bezić. I must agree with your opinion in line of the prognostically favorable subtype of breast NST cancer.
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