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The mysterious grading of breast cancer: How is its aggressiveness determined?
The classification of breast cancer aims to divide breast cancer into several categories based on different criteria. These different classifications not only help with diagnosis, but also influence the choice of treatment options. Classification based on tumor histology, grade, stage, and protein and gene expression can help the medical team provide the best treatment plan for the patient's specific situation. These classifications are continually updated as our understanding of cancer cell biology improves.
The main purpose of classification is to select the most appropriate treatment method according to the characteristics of different breast cancers.
There are various grading systems for breast cancer, but they are mainly divided into four aspects, which all affect treatment response and prognosis. A comprehensive classification should include histopathological type, grade, stage (TNM), receptor status, and genetic testing results. These classification methods are interdependent and work to predict the patient's disease course and likelihood of responding to treatment.
Histological classification
In addition to the common ductal carcinoma, breast cancer can also be classified according to its histological characteristics, including carcinoma in situ (Carcinoma in situ) and invasive cancer. Carcinoma in situ is a proliferation of cancer cells that have not invaded surrounding tissue. It usually has a good prognosis, with a five-year survival rate of 97-99%. In contrast, invasive cancer, which penetrates surrounding tissue, is more critical and often requires more invasive treatment.
Grading classification
Tumor grading is primarily based on the histological similarity of cancer cells. This classification system usually grades tumor cells based on how similar their appearance is to normal breast tissue, and is usually divided into three levels:
- Lowly differentiated (Grade 1): The cell structure is similar to normal cells, the cell proliferation rate is low, and the prognosis is good.
- Moderate differentiation (Grade 2): The similarity between the cell structure and normal cells is reduced, and the proliferation rate is relatively increased.
- Highly differentiated (Grade 3): The cell structure changes significantly and is no longer similar to normal cells, and the prognosis is poor.
The more poorly differentiated a cancer is, the less favorable its prognosis is.
Staging classification
Staging is an assessment of how far the cancer has spread in the body, and this information is crucial to choosing the right treatment. The TNM staging system for breast cancer carries out detailed staging based on the size of the primary tumor, the extent of lymph node involvement, and the presence of distant metastasis. For example:
- Stage 0: Carcinoma in situ, such as intraductal carcinoma (DCIS).
- Stage I: The tumor is less than 2 cm in diameter and has not spread to lymph nodes.
- Stage II: The tumor is larger, or at least one lymph node is involved.
- Stage III: Including severe local spread and obvious lymph node involvement.
- Stage IV: Cancer that metastasizes far away has a poor prognosis.
Different stages are closely related to prognosis, and higher stages are usually accompanied by worse prognosis. Understanding these classifications is not only helpful for medical workers, but also allows patients and families to be more aware of the challenges they face during treatment.
Receptor status
The receptor status of breast cancer cells is one of the key factors affecting treatment selection, especially the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu receptor. Tumors that are receptor-positive (such as ER+, PR+, and HER2+) often respond better to hormone therapy or targeted therapy, while tumors that are receptor-negative (such as triple-negative breast cancer) may require more aggressive treatment options.
Gene classification
With the development of genetic testing technology, it is becoming increasingly important to understand the specific genetic mutations of breast cancer. When specific gene mutations or expression patterns are identified in cancer cells, this information can be used to select targeted or targeted treatments to maximize treatment effectiveness.
Other classification methods
With the advancement of technology, many computational models (such as Adjuvant) can integrate information at various classification levels and provide visual enhancement tools to assist medical decision-making. This integration not only provides a comprehensive diagnosis, but also enables personalized treatment selection based on the patient's specific situation.
In summary, the classification system of breast cancer not only reflects the complexity of the disease, but also implies customized treatment plans that meet the needs of different patients. In the future, as our understanding of breast cancer biology continues to deepen, we may be able to discover more new factors that affect breast cancer treatment. This is not only a task for clinical researchers, but also a health issue that calls for public attention. Are you ready to face this life-or-death issue?
