METHODS: This cross-sectional study involved 140 invasive breast cancer cases at Hospital Universiti Sains Malaysia. The study consisted of two phases: Phase 1, which developed nuclear scoring criteria using histopathological images from 2013-2017, and Phase 2, which validated these criteria on cases from 2018-2019. Two sets of samples were included for the study, with 120 cases analyzed in Phase 1 and 53 cases in Phase 2. Descriptive statistics and normality tests assessed differences in LNS and NSD across original nuclear grades.