Collaborative Stage

Note 1: AJCC recommends the Nottingham combined histologic grade (Elston-Ellis modification of the Scarff-Bloom-Richardson grading system). Terms seen on pathology reports may include: Bloom-Richardson (BR), modified Bloom-Richardson, BR, BR grading, Scarff-Bloom-Richardson, SBR grading, , Elston-Ellis modification of Bloom-Richardson score, Nottingham modification of Bloom-Richardson score, Nottingham modification of Scarff-Bloom-Richardson, Nottingham-Tenovus grade, or Nottingham grade.
Note 2: Code the tumor grade using the following priority order: a). BR scores 3-9; b). BR grade (low, intermediate, high).
Note 3: BR score may be expressed as a range, 3-9. The score is based on three morphologic features of "invasive no-special-type" breast cancers (degree of tubule formation/histologic grade, mitotic activity, nuclear pleomorphism/nuclear grade of tumor cells). If a report describes any of the factors with words (low, intermediate, high) rather than numbers, do not attempt to translate these words into a score or number; use codes 110-130.
Note 4: If only a grade of 1 through 4 is given with no information on the score and it is unclear if it is a Nottingham or BR Grade, code 999.
Note 5: Code the highest score if multiple scores are reported. For examples, different scores may be reported on multiple pathology reports for the same primary cancer; different scores may be reported for multiple tumors assigned to the same primary cancer.

Code	Description
030	Score of 3
040	Score of 4
050	Score of 5
060	Score of 6
070	Score of 7
080	Score of 8
090	Score of 9
110	Low Grade, Bloom-Richardson (BR) grade 1, score not given
120	Medium (Intermediate) Grade, BR grade 2, score not given
130	High Grade, BR grade 3, score not given
988	Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 988 may result in an edit error.)
998	No histologic examination of primary site
999	Neither BR grade nor BR score given Unknown or no information Not documented in patient record

CS Site-Specific Factor 7
Nottingham or Bloom-Richardson (BR) Score/Grade