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Understanding markers

simonna Member Posts: 2
edited August 2022 in Stage I Breast Cancer

Hi guys!

I am coming with a question, maybe some of you know.

What is FC and A scores on a breast biops?

For example, I have HP G2 grading (FC=3, A=2, M=1).

I know M stands for methastasis, but FC and A no idea. I searched on the web but wasn't able to find explanations

Thank you all so very much!


  • specialk
    specialk Member Posts: 9,221
    edited August 2022

    I am not sure what your FC and A stand for on your report, but I suspect that the M is for mitosis, rather than metastasis - there is no pathological correlation between grade and metastasis. People new to a breast cancer diagnosis can sometimes confuse grade and stage, and it is he M in stage stands for metastasis (in the TNM system), it is a lot to understand and take in! Here is some info from Oncolink regarding grade that explains what the three scores are looking at and how they are added together to come up with the grade number. I am not sure if the tubule formation and the nuclear pleomorphism are represented in your report by different letters (the FC and the A), but you should inquire about this with your surgeon.

    Histological Grade

    The histological grade is reported using the "Bloom Richardson Scale" or "Nottingham Score." It is a combination of nuclear grade, mitotic rate, and tubule formation, which describe what the tumor cells look like under a microscope. Histological grade predicts how aggressive the tumor cells are. This scoring system is detailed and often does not affect treatment decisions, so it is not especially useful for treatment options. However, you will see it on the report and may be interested in what it means. In general, high grade tumors are more likely to recur (come back) when compared to low grade tumors.

    • Nuclear Grade: A score is given from 1 to 3, based on what the nucleus of the cancer cells looks like compared to normal cells. In nuclear grade 1, the nucleus of the cancer cells looks more like normal cells, while in nuclear grade 3, it looks the least like normal cells.
    • Mitotic Rate: Describes how quickly the cancer cells are multiplying or dividing using a 1 to 3 scale: 1 being the slowest, 3 the quickest.
    • Tubule formation: This score represents the percent of cancer cells that are formed into tubules.
      • A score of 1 means more than 75% of cells are in tubule formation.
      • A score of 2 is between 10 and 75%.
      • A score of 3 is used when less than 10% of cells are in tubule formation.

    The three scores (nuclear grade, mitotic rate, and tubule formation) are then combined for a total score between 3 (1+1+1) and 9 (3+3+3). This score makes up the histological grade. You may see the three values and total score, or just the final grade.

    • Score of 3,4 or 5: Well differentiated or low grade (Grade 1).
    • Score of 6 or 7: Moderately differentiated or intermediate grade (Grade 2).
    • Score of 8 or 9: Poorly differentiated or high grade (Grade 3).
  • simonna
    simonna Member Posts: 2
    edited August 2022

    Thank you very much for replying & the info provided.


  • barbara4
    barbara4 Member Posts: 10
    edited August 2022


    Thank you for your explanation. Do you know if the scoring for idc and dcis is the same ?