Is it a Gleason 3+4 or 4+3?
If you just do the math, the sum is the same – 7. But there is a significant difference between a prostate cancer determined by a pathologist to be Gleason 3 + 4, which has more lower-grade cells in it, and one that is labeled Gleason grade 4 + 3. Prostate cancer cells are graded on a formula system developed years ago by a pathologist named Gleason. He identified and numbered patterns of prostate cancer in grades of aggressiveness by determining which types of cells appear most commonly in a biopsy sample (and later, in the removed prostate specimen). Cancer given the highest Gleason grade – 8, 9, and 10 – is the most aggressive and in need of treatment. Gleason 7 cancer is different, depending on whether there are more cells labeled 3 or 4.
In recent work, Veltri and colleagues investigated
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