Figure 2

Relationship between histological grade and breast cancer-specific survival. (a) In the old Nottingham series (1977 to 1989), no systemic therapy was offered to the patients. Of the 1,816 patients, 404 (17.7%) had grade 1 tumors (gray curve), 621 (36.2%) had grade 2 (blue curve), and 791 (46.1%) had grade 3 (black curve) (χ² = 97.5, P < 0.0001). (b) In the recent Nottingham series (1990 to 2002), systemic therapy was offered to the patients according to Nottingham Prognostic Index and estrogen receptor expression as described previously [11]. Of the 3,579 patients, 677 (18.9%) had grade 1 tumors (gray curve), 1,383 (38.6%) had grade 2 (blue curve), and 1,519 (42.4%) had grade 3 (black curve) (χ² = 195.5, P < 0.0001). Analysis of grade 1 and 2 only showed statistical survival difference (χ² = 20.7, P < 0.0001). Both series are consecutive and included estrogen receptor-positive and -negative and lymph node-negative and -positive cases [11, 75, 76].