Histopathological malignancy grading and familiality in an unselected series of 1303 women with breast carcinoma.

Histopathological characteristics were studied in 1303 women consecutively diagnosed as having breast cancer. They comprised a total material from a defined geographical area. The significance and distribution of malignancy grades according to Ackerman's system were evaluated in this unselected material. Their relationships with other morphological characteristics and with the occurrence of axillary node metastases with or without periglandular growth were appraised. These characteristics were also related to the familial occurrence of breast cancer. The distribution according to the Ackerman grading was: type I 39 cases (3%), type II 75 (6%), type III: 2 95 (7%), type III:1 793 (61%) and type IV 301 cases (23%). The degree of differentiation (partly by definition) correlated highly significantly with the malignancy grading. Axillary lymph nodes were available for histopathological examination in 844 cases. In malignancy types I and II there were no lymph node metastases, in type III:2 2%, in III:I 40% and in type IV 77%. Periglandular growth was found only in type III:I and IV--in 9 and 59%, respectively. Familial occurrence of breast cancer was confirmed in 19% of the patients. Familial and non familial cases did not differ significantly with respect to the distribution of malignancy grades, degree of differentiation, grade of cell polymorphism or frequency of lymph node metastases.