Academic Pathology
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Nottingham Breast Pathology Research Group


The Nottingham Breast Pathology Group's research is focused towards use of histological and molecular methods in diagnosis and clinical and basic research and specifically to improve the existing classification systems for breast disease.



Research issue

Our working hypothesis is that development of a modern clinically relevant classification system based on morphological and molecular genetic alterations will identify new targets for therapeutic development and improve patient management through improved prognostic information and therapeutic response prediction.

What we are doing about...

1. Breast disease classification

The Nottingham/Tenovus Breast Cancer Research Group and Nottingham Breast Pathology Research Group at Nottingham City Hospital have a longstanding research interest and international track record in classification of breast cancer diagnosis of breast disease, evaluation of prognostic factors in breast cancer and understanding of the mechanisms governing hormone response in breast cancer.

We have developed a histological grading system, which has become the international gold standard for histological classification (WHO, UICC, EU and UK).

Ongoing research

We have active research programmes in each of the main molecular classes of breast cancer, Oestrogen receptor positive luminal, Triple negative basal and HER2 positive. These programs investigate molecular variation in terms of improving disease classification with respect to patient outcome and response to therapy.



2. Prognostic markers

The Nottingham Prognostic Index, also developed by the group, is regarded as the most effective system for clinical decision support in routine clinical management.

These systems are largely based on morphological assessment of tumour tissue sections and are subject to problems of interobserver variation.

As a consequence our group have examined a wide range of potential objective prognostic markers and have over the last 10 years been exploring the hypothesis that a novel classification of breast cancer based on phenotypic and molecular genetic characteristics will provide a more robust system for classification and therapeutic decision-making.

This work is being carried out in collaboration with groups in Computer Sciences, Nottingham University, Nottingham Trent University, Breakthrough, ICR, London, Cambridge University, Tenovus Institute, Cardiff and Memorial Sloan Kettering, New York. 

Update to Nottingham Prognostic Index

We are developing an updated version of the Nottingham Prognostic Index – NPI+ which takes account of molecular sub class as well as more focused use of prognostic factors.



Current projects

  • NPI+ I new prognstic tool in breast cancer incorporating clinicopathological and molecular variables
  • DNA damage response in breast cancer: moving from individual genes to pathways and networks
  • Oestrogen receptor and HER2 expression in breast cancer: molecular interaction and clinical implications 
  • Mechanisms underlying lymphovascular invasion in breast cancer
  • Molecular characterisation and outcome prediction of DCIS
  • Investigating Breast Cancer heterogeneity
  • Low grade breast neoplasia family



World-leading breast cancer expertise

Professor Ian Ellis named among the world’s top 20 most influential experts on breast cancer


Our research is published in leading peer-reviewed journals. Please see our members' profiles for publication details.




Nottingham Breast Pathology Masterclass 21-22 July 2015



Email Ian Ellis, Professor of Cancer Pathology

Email Emad Rakha, Associate Professor and Consultant Pathologist














Academic Pathology

The University of Nottingham
School of Medicine, Queen's Medical Centre
Nottingham, NG7 2UH

telephone: +44 (0)115 969 1169