In the Nottingham Grading System for breast carcinoma, which three histological features are scored from 1–3 each?

• A Necrosis, lymphovascular invasion, and mitotic count
• B Tumour size, lymph node status, and mitotic count
• C ER status, PR status, and Ki-67 index
• D Nuclear pleomorphism, tubule formation, and mitotic count ✓

Explanation

The Nottingham (Elston-Ellis) grading system scores three histological parameters — nuclear pleomorphism (nuclear grade), tubule formation (degree of glandular differentiation), and mitotic count — each on a scale of 1–3, giving a combined score of 3–9 that determines Grade 1 (3–5), Grade 2 (6–7), or Grade 3 (8–9). Lymphovascular invasion, necrosis, and receptor status are not part of this grading system.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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