Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis

Table 1 Summary of the criteria to determine the nuclear grade for the DCIS classifications studied

Holland
	High grade	Intermediate grade	Low grade
Nuclei	Pleomorphic nuclei, anisonucleosis, irregular location, usually but not always large	Slight pleomorphism, nuclei showing some variation in size, outline and spacing	Monomorphic nuclei of uniform size, regular outline and spacing, usually small
Chromatin	Vesicular	Fine to coarse	Uniform, fine
Nucleoli	1 or more	Infrequent	No nucleoli
Mitoses	Often present	Occasionally present	Rare
Van Nuys
	High grade	Intermediate grade	Low grade
Nuclei diameter	>2 RBC	1.5–2 RBC	1–1.5 RBC
Chromatin	Vesicular	Fine to coarse	Uniform, fine
Nucleoli	1 or more	Infrequent	No nucleoli
Comedo-necrosis	Present or absent	Present	Absent
Black Modified Nuclear Grade
	High grade	Intermediate grade	Low grade
Nuclei	Pleomorphic nuclei, anisonucleosis, irregular location, usually but not always large	Slight pleomorphism, nuclei showing some variation in size, outline and spacing	Monomorphic nuclei of uniform size, regular outline and spacing, usually small
Nuclei diameter	Up to 3 times the diameter of normal nuclei	Up to 2 times the diameter of normal nuclei	Same as normal nuclei
Chromatin	Vesicular	Fine to coarse	Uniform, fine
Nucleoli	1 or more	Infrequent	No nucleoli
Mitoses	Often present	Occasionally present	Rare

ISSN: 1746-1596