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To overcome these limitations, some additional quantitative parameters can be tentatively suggested, including the number of mitoses (as in the Nottingham grading system for breast cancer), (20) nuclear size and shape (as in the Fuhrman grading system for renal cell carcinoma), (19) the diameter of the microscopic field, and the number of fields to be evaluated.
In 133 cases the slide from the block sent for Oncotype DX analysis was reviewed by 1 pathologist and a nuclear grade, tubule score, and mitotic count score were determined with the Nottingham grading system. (7) In 5 cases the slides were not available for review.
We found that in all cases with both a negative progesterone receptor result, as determined via immunohistochemistry, and a mitotic count score of 3 with Nottingham grading system, (7) the Recurrence Score was high.
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