Histologic grading has been a simple and inexpensive method to assess tumor behavior and prognosis of invasive breast cancer grading, thereby identifying patients at risk for adverse outcomes, who may be eligible for (neo)adjuvant therapies. Histologic grading needs to be performed accurately, on properly fixed specimens, and by adequately trained dedicated pathologists that take the time to diligently follow the protocol methodology. In this paper, we review the history of histologic grading, describe the basics of grading, review prognostic value and reproducibility issues, compare performance of grading to gene expression profiles, and discuss how to move forward to improve reproducibility of grading by training, feedback and artificial intelligence algorithms, and special stains to better recognize mitoses. We conclude that histologic grading, when adequately carried out, remains to be of important prognostic value in breast cancer patients.

组织学分级一直是评估浸润性乳腺癌分级的肿瘤行为和预后的一种简单且廉价的方法，从而确定可能有资格接受（新）辅助治疗的有不良后果风险的患者。组织学分级需要在正确固定的标本上准确进行，并由经过充分培训的专业病理学家花时间认真遵循协议方法。在本文中，我们回顾了组织学分级的历史，描述了分级的基础知识，回顾了预后价值和可重复性问题，将分级性能与基因表达谱进行了比较，并讨论了如何通过培训、反馈和人工智能算法和特殊染色剂可以更好地识别有丝分裂。我们得出结论，组织学分级，