More commonly, the biopsy is processed routinely, and a diagnosis is made. If a malignancy is found, the biopsy can be further studied via immunoperoxidase staining to determine receptor status. Grading and Staging A completely uniform system of grading for breast cancers is not possible because of the wide variety of histologic cell types. The cell types themselves, along with the invasiveness of the cancer, help to predict the biologic behavior of the cancer. The grade is calculated by adding the above scores.
Carcinomas have a propensity to spread via lymphatics.
Breast cancers, when they metastasize, often go first to the axillary lymph nodes where most lymphatics from the breast drain. This term arose from the grossly red to orange and firm, indurated appearance of such a lesion. More distant metastases are also possible. Supraclavicular lymph nodes can be involved. Other organs can be sites of metastases, and such sites as lung, bone, and liver are more common.