Nuclear pleomorphism. Do the tumor nuclei look uniform similar to the normal breast duct epithelial cells, or are they larger, more irregular, and darker (hyperchromatic)?.
• Uniform nuclei similar to normal breast epithelium = 1 point • Moderate nuclear variation = 2 points • Marked nuclear variation, hyperchromasia, irregular large nucleoli = 3 points These are added to yield a Final Elston Grade: • Final score 3-5=Elston grade 1 • Final score 6-7=Elston grade 2 • Final score 8-9=Elston grade 3
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