Loading
How much of the cancer in a biopsy is the more aggressive pattern 4 rather than the slower pattern 3. Two men can both be told grade group 2, one with 5 per cent pattern 4 and one with 45 per cent, and the number is what separates them.
Answer a few questions from a report and read the guideline statement that applies, quoted word for word with its source. Educational aids to prepare for an appointment, not advice.
Grade group 2 is Gleason 3+4=7: predominantly well-formed glands with a lesser component of poorly formed, fused or cribriform glands. 'A lesser component' covers everything from a trace to just under half, and the difference matters, because a man with a few per cent of pattern 4 is a candidate for active surveillance and a man approaching half is not. The Royal College of Pathologists made the percentage of Gleason pattern 4 a core item for core biopsies in its October 2024 revision of the UK dataset, following recommendations from both ISUP and the Genitourinary Pathology Society to report it in biopsies with grade group 2 and 3 disease. The dataset notes that methods of estimating the percentage vary between pathologists, so the figure is an estimate rather than a measurement.
The number also feeds the tools that turn a report into a decision. PREDICT Prostate uses the number of positive cores and the presence of intraductal or cribriform growth alongside the grade; the Cambridge Prognostic Groups separate grade group 2 from grade group 3 precisely because Gleason 3+4 and 4+3 behave differently; and the corpus's report reader asks for percentage pattern 4 as a field on the prostate form. If a report does not give it and the grade group is 2 or 3, it is a reasonable thing to ask the team for.
About three quarters of cancers arise in the peripheral zone at the back of the gland, the part a finger or a biopsy needle reaches; drainage is to the obturator and iliac nodes.
Same organ: Ductal adenocarcinoma of the prostate, Localised prostate cancer, very low and low risk, Localised prostate cancer, intermediate risk, Localised prostate cancer, high and very high risk, Biochemical recurrence of prostate cancer, Metastatic hormone-sensitive prostate cancer, Non-metastatic castration-resistant prostate cancer, Metastatic castration-resistant prostate cancer, Neuroendocrine and small-cell prostate cancer
Showing the organ this term concerns: Prostate cancer.
Shares Cribriform growth pattern in prostate cancer, Intraductal carcinoma of the prostate (IDC-P), Cambridge Prognostic Group (CPG 1 to 5), Gleason score / Grade Group.
Shares Cambridge Prognostic Group (CPG 1 to 5), Active surveillance and observation, Localised prostate cancer, very low and low risk, Prostate cancer.
Shares Cribriform growth pattern in prostate cancer, Intraductal carcinoma of the prostate (IDC-P), Gleason score / Grade Group, Localised prostate cancer, intermediate risk.
Shares Cribriform growth pattern in prostate cancer, Intraductal carcinoma of the prostate (IDC-P), Prostate cancer.
Shares Active surveillance and observation, Gleason score / Grade Group, Localised prostate cancer, intermediate risk, Localised prostate cancer, very low and low risk.
Shares Cambridge Prognostic Group (CPG 1 to 5), Active surveillance and observation, Localised prostate cancer, very low and low risk, Prostate cancer.
Shares Active surveillance and observation, Gleason score / Grade Group, Localised prostate cancer, intermediate risk, Localised prostate cancer, very low and low risk.
Shares Cambridge Prognostic Group (CPG 1 to 5), Active surveillance and observation, Gleason score / Grade Group, Localised prostate cancer, very low and low risk.