Retrospective Study of Survival and Clinico Pathological Characteristics of Different Histopathological Grades of Newly Diagnosed Breast Cancer Patients: A Rural Cancer Centre Experience

Abstract Background: Histopathological grading is an essential prognostic tool in breast cancer management. In rural India, limited healthcare access often leads to late diagnosis and poor survival. Understanding the clinicopathological profile of various tumor grades can help to optimize treatment strategies in resource-constrained settings. Aim: To evaluate the clinico-pathological characteristics and survival outcomes associated with different histological grades of newly diagnosed breast cancer patients in a rural cancer centre. Methods: A retrospective observational study was conducted on 486 patients diagnosed with breast cancer between June 2021 and June 2023. Tumors were graded using the Nottingham system. Demographic, pathological, and treatment details were analyzed. Survival outcomes—disease-free survival (DFS) and overall survival (OS)—were assessed using Kaplan-Meier analysis, and associations were evaluated using Chi-square and log-rank tests. Results: Of the 486 patients, 21.0% had Grade I, 45.7% Grade II, and 33.3% Grade III tumors. Higher tumor grade was significantly associated with larger size, lymph node positivity, HER2 positivity, and triple-negative phenotype (p<0.001). Hormone receptor positivity declined with increasing grade. Grade I tumors had superior 3-year DFS (89.2%) and OS (93.1%) compared to Grade III (58.1% and 71.6%, respectively) (p<0.001). BMI was also correlated with grade and survival—obese patients (≥30 kg/m²) had a higher proportion of Grade III tumors and poorer outcomes. Conclusion: Histological grade is a strong predictor of aggressive tumor biology and poor prognosis in breast cancer. In rural settings, early diagnosis and grading-based risk stratification can guide effective treatment planning. Improving access to diagnostic tools and targeted therapies is vital to reducing rural-urban disparities in breast cancer outcomes.