Recommendations of the 2005 ISUP Consensus Conference for Reporting the Gleason Score for a Patient with Prostate Cancer If a Tertiary Pattern is Present

If 3 patterns are identified in a biopsy:

(1) the first component of the Gleason score is the most prevalent pattern

(2) the second component is the higher of the 2 remaining grades, irrespective of the amount present

Patel et al demonstrated that a patient with patterns 3 and 4 and with a tertiary pattern 5 behaved worse than a patient with a score of 7.