RESUMO
PURPOSE: The existing scoring systems HERSI (Kajo 2007) and DIVER (Taucher 2003) are based on the assumption that tumor grade, estrogen (ER) and progesterone receptors (PR) equally affect HER-2 status. Our idea was to propose a simplified scoring system (SIMPLY) which employs tumor characteristics according to their significance. METHODS: A total of 621 cases of invasive breast carcinoma with determined tumor grade, size, histological type, ER, PR, lymph node metastasis, lymphovascular invasion, age and HER-2 status were included in the study. The main features of the proposed system were simplicity in the scoring of ER and PR and emphasizing the role of tumor grade as the most important predictor of HER-2. RESULTS: The percentage of cases for which HER-2 assessment could be postponed was 33.98% for HERSI, 42.51% for DIVER, 53.62% for SIMPLY (score 5), and 66.34% for SIMPLY with a subgroup (score 3.5-5), when all scoring systems were applied to the same data set. CONCLUSION: In the SIMPLY group with the highest score, HER-2 assessment could be delayed, since the results from HER-2 assessment were not expected to affect patient management. SIMPLY could be helpful in improving patient care in countries lacking financial resources.