Feline mammary tumors: comparison of histological grading systems and Nottingham prognostic index in a 3-year survival study (Part II).
Rodrigues-Jesus J, Canadas-Sousa A, Oliveira P, Petrucci GN, Marrinhas C, Craveiro H, Ribeiro AD, Gregório H, Tinoco F, Goulart A, Felga H, Pastorinho R, Vilhena H, Figueira AC, Dias-Pereira P · Veterinary Journal · 8 March 2026
Include vet-NPI with EE/MMEE grading systems to improve FMC prognosis assessment.
This study evaluated and compared four histological grading systems for feline mammary carcinomas (FMC): the traditional Nottingham (EE) system, a mitotic-modified version (MMEE), a revised system (REE), and a novel grading system (MGS). The researchers analyzed 3-year survival data from a cohort of cats with mammary tumors to assess prognostic value. Cohen's kappa analysis showed poor to fair agreement between the EE system and the three proposed alternatives. While all grading systems associated with overall survival in univariate analysis, only EE and REE remained significant after multivariate adjustment. The REE and MGS systems correlated with tumor-specific survival, though MGS lost significance in multivariate analysis. Notably, MGS was the only system significantly associated with disease-free interval in both univariate and multivariate analyses. The authors concluded that mitotic count thresholds may be inadequate across different settings and recommend including the veterinary Nottingham Prognostic Index (vet-NPI) in routine diagnostic reports using EE and MMEE grading to improve tumor-specific survival prognostication.
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