Cell grade and implication for prognosis if spread to lymph nodes

lynn1950
lynn1950 Member Posts: 2,570
edited March 2014 in Breast Cancer #1
Does anyone have information about cell grade (I'm a 3) and implications for metastases?
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  • mmontero38
    mmontero38 Member Posts: 1,510
    Lynn: I copied this from the
    Lynn: I copied this from the National Cancer Institute. I hope this answers your question. My tumor was also a Grade 3 and I was diagnosed with invasive carcinoma in June 2007. I had a right modified radical mastectomy. They did a sentinel node mapping, removed 7 lymph nodes and they were all clean. I went through 8 rounds of cytoxan, adriamycin and 5FU. My oncologist stated that because of the tumor grade he was treating me very aggressively. I hope this helped. Hugs, Lili

    Tumor grade is a system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread.

    # What do the different tumor grades signify?

    Based on the microscopic appearance of cancer cells, pathologists commonly describe tumor grade by four degrees of severity: Grades 1, 2, 3, and 4. The cells of Grade 1 tumors resemble normal cells, and tend to grow and multiply slowly. Grade 1 tumors are generally considered the least aggressive in behavior.

    Conversely, the cells of Grade 3 or Grade 4 tumors do not look like normal cells of the same type. Grade 3 and 4 tumors tend to grow rapidly and spread faster than tumors with a lower grade.

    The American Joint Commission on Cancer recommends the following guidelines for grading tumors (1):
    Grade

    GX
    Grade cannot be assessed (Undetermined grade)
    G1
    Well-differentiated (Low grade)
    G2
    Moderately differentiated (Intermediate grade)
    G3
    Poorly differentiated (High grade)
    G4
    Undifferentiated (High grade)
  • lynn1950
    lynn1950 Member Posts: 2,570

    Lynn: I copied this from the
    Lynn: I copied this from the National Cancer Institute. I hope this answers your question. My tumor was also a Grade 3 and I was diagnosed with invasive carcinoma in June 2007. I had a right modified radical mastectomy. They did a sentinel node mapping, removed 7 lymph nodes and they were all clean. I went through 8 rounds of cytoxan, adriamycin and 5FU. My oncologist stated that because of the tumor grade he was treating me very aggressively. I hope this helped. Hugs, Lili

    Tumor grade is a system used to classify cancer cells in terms of how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread.

    # What do the different tumor grades signify?

    Based on the microscopic appearance of cancer cells, pathologists commonly describe tumor grade by four degrees of severity: Grades 1, 2, 3, and 4. The cells of Grade 1 tumors resemble normal cells, and tend to grow and multiply slowly. Grade 1 tumors are generally considered the least aggressive in behavior.

    Conversely, the cells of Grade 3 or Grade 4 tumors do not look like normal cells of the same type. Grade 3 and 4 tumors tend to grow rapidly and spread faster than tumors with a lower grade.

    The American Joint Commission on Cancer recommends the following guidelines for grading tumors (1):
    Grade

    GX
    Grade cannot be assessed (Undetermined grade)
    G1
    Well-differentiated (Low grade)
    G2
    Moderately differentiated (Intermediate grade)
    G3
    Poorly differentiated (High grade)
    G4
    Undifferentiated (High grade)

    cell grade
    Thanks for the information. I know that the grade (mine was a 3 on a 3 grade scale) increases the risk of recurrence and metastases. My cancer was treated aggressively for the same reason. I'm just wondering between tumor size, cell grade, and lymph node involvement if they all weigh equally in terms of prognosis.
  • Eil4186
    Eil4186 Member Posts: 949
    I understand your concern.
    Lynn, I too have always wondered about the grades. As Lilli wrote, 1 is considred to be low grade and more aggressive with each step up on the scale. My tumor was a grade one. My nuclear grade was a grade 3 however. My other two numbers were ones, so overall I scored a 5. Six would have been a grade 2. Since a nuclear grade of 3 means that the necleus of the cells were very abnormal I have always wondred if that would make a recurrence more aggressive than the original. My oncologist said that it(cancer) would have the potential to BECOME more aggressive due to the nuclear grade.

    But I guess I wish I could have more specific information or statistics. So I understand your concern about the grade of your cancer. If you happen upon some good information or resources on this topic, please let me know, ok? I will do the same. Thanks, Eil
  • lynn1950
    lynn1950 Member Posts: 2,570
    Eil4186 said:

    I understand your concern.
    Lynn, I too have always wondered about the grades. As Lilli wrote, 1 is considred to be low grade and more aggressive with each step up on the scale. My tumor was a grade one. My nuclear grade was a grade 3 however. My other two numbers were ones, so overall I scored a 5. Six would have been a grade 2. Since a nuclear grade of 3 means that the necleus of the cells were very abnormal I have always wondred if that would make a recurrence more aggressive than the original. My oncologist said that it(cancer) would have the potential to BECOME more aggressive due to the nuclear grade.

    But I guess I wish I could have more specific information or statistics. So I understand your concern about the grade of your cancer. If you happen upon some good information or resources on this topic, please let me know, ok? I will do the same. Thanks, Eil

    I'll post anything I find out.
    "the potential to become more aggressive" is both vague and scary!
  • mimivac
    mimivac Member Posts: 2,143
    lynn1950 said:

    I'll post anything I find out.
    "the potential to become more aggressive" is both vague and scary!

    Grade 3
    I'm a grade 3 tumor as well. Just remember that chemo works best on the most aggressive tumors. My doctor did not discuss grade with me as a part of prognosis, just size and lymph node involvement. The higher grade meant that I would go with a more aggressive treatment.

    Mimi
  • lynn1950
    lynn1950 Member Posts: 2,570
    Thanks for your encouraging words
    I didn't know that about chemo. Good information. Thank you so much. Lynn
  • Eil4186
    Eil4186 Member Posts: 949
    lynn1950 said:

    I'll post anything I find out.
    "the potential to become more aggressive" is both vague and scary!

    You said it.
    Yeah, I know!!!! Thats what I was thinking. Any recurrence would be hard to take, but the knowledge that a recurrence could potentially be more aggressive for me than the first time around certainly is scary. I guess they can't really ever accurately predict how any cancer might behave. Its just too evil a disease. Eil
  • Eil4186
    Eil4186 Member Posts: 949
    mimivac said:

    Grade 3
    I'm a grade 3 tumor as well. Just remember that chemo works best on the most aggressive tumors. My doctor did not discuss grade with me as a part of prognosis, just size and lymph node involvement. The higher grade meant that I would go with a more aggressive treatment.

    Mimi

    Uh oh.....
    I didn't know that chemo does not work as well with less aggressive cancers. Now I am worried.......
  • mimivac
    mimivac Member Posts: 2,143
    Eil4186 said:

    Uh oh.....
    I didn't know that chemo does not work as well with less aggressive cancers. Now I am worried.......

    I didn't mean that it
    I didn't mean that it doesn't work as well -- just that chemo works on fast dividing cells, so the faster dividing the cells (the more aggressive), the more the chemo will target them. If you have a less aggressive cancer, you are already starting from a better place. That's why they do the oncatype test to determine whether you need chemo in the first place: if you have a very low chance of recurrence (a less aggressive cancer), the chemo won't lower that risk significantly. BUT, that's good b/c you are starting from a place of low risk. Does that make sense? I didn't mean to worry you.

    Mimi
  • Marcia527
    Marcia527 Member Posts: 2,729
    My doctor didn't even tell
    My doctor didn't even tell me my cell grade. If he did I didn't hear or didn't understand. It's just a lot to assimilate in the beginning.
  • mimivac
    mimivac Member Posts: 2,143
    Marcia527 said:

    My doctor didn't even tell
    My doctor didn't even tell me my cell grade. If he did I didn't hear or didn't understand. It's just a lot to assimilate in the beginning.

    I sometimes wish this
    Although I think it's good to be knowledgeable, sometimes I wish my doctor hadn't discussed my cell grade with me (actually, she didn't; I read it off of my medical reports). It doesn't change my treatment and it only serves to worry me. I tend to focus on the bad stuff, though, so maybe that's just me.
  • lynn1950
    lynn1950 Member Posts: 2,570
    focus
    I tend to focus on the worrisome stuff, too. I wish I could find my positive attitude and stuff the negative in a box on a shelf somewhere in the basement and forget about it! Lynn
  • mimivac
    mimivac Member Posts: 2,143
    lynn1950 said:

    focus
    I tend to focus on the worrisome stuff, too. I wish I could find my positive attitude and stuff the negative in a box on a shelf somewhere in the basement and forget about it! Lynn

    Stuff the negative stuff
    I think that's just what we should do, Lynn. There's a lot of good stuff to focus on, and it helps absolutely nothing to dwell on things that we cannot change. I know, easier said than done, but it's something to strive for.

    Mimi
  • Marcia527
    Marcia527 Member Posts: 2,729
    lynn1950 said:

    focus
    I tend to focus on the worrisome stuff, too. I wish I could find my positive attitude and stuff the negative in a box on a shelf somewhere in the basement and forget about it! Lynn

    Better yet don't put that
    Better yet don't put that box of negative stuff in the basement, put it in the trash and never think of it again!
  • lynn1950
    lynn1950 Member Posts: 2,570
    Marcia527 said:

    Better yet don't put that
    Better yet don't put that box of negative stuff in the basement, put it in the trash and never think of it again!

    Taking out the trash
    If only I could. Everyone says that it gets better as time passes, but I am really struggling with depression and anxiety. I am trying all the stuff I can: meds, acupuncture, counseling, meditation, praying...I want "me" back so bad!
  • mimivac
    mimivac Member Posts: 2,143
    lynn1950 said:

    Taking out the trash
    If only I could. Everyone says that it gets better as time passes, but I am really struggling with depression and anxiety. I am trying all the stuff I can: meds, acupuncture, counseling, meditation, praying...I want "me" back so bad!

    I know what you mean, Lynn
    I am struggling, too. But I really do believe that it will get better. Sometimes just when you least expect it, the clouds start to clear. I look at it this way: the body and mind cannot sustain a state of permanent fear and anxiety. Eventually, it will return to a sense of normalcy, the "you" that you crave. It may be a slightly different you, but you will be back. I think it's great that you are trying different ways to help yourself. That is half the battle. I know that your efforts will pay off, too. If you keep at it, I will too. Take it a day at a time and just let yourself feel what you feel. Day by day, step by step, you are recovering and becoming a beter you.

    Mimi
  • lynn1950
    lynn1950 Member Posts: 2,570
    thank you
    Mimi, You knew just the right thing to say. Thank you for the encouraging words. Today was a better day, for no good reason at all. I wish you a hopeful day for today and tomorrow and tomorrow and tomorrow.... Lynn
  • mmontero38
    mmontero38 Member Posts: 1,510
    lynn1950 said:

    thank you
    Mimi, You knew just the right thing to say. Thank you for the encouraging words. Today was a better day, for no good reason at all. I wish you a hopeful day for today and tomorrow and tomorrow and tomorrow.... Lynn

    Lynn and Mimi. It does get
    Lynn and Mimi. It does get better. Doesn't feel like it will in the beginning. Everyday your waking thought is cancer. You worry if it has spread, you question every little ache, it seems like the diagnosis takes over you very existence. But, once you are near the end of your treatments, it starts to get better. Then, when you are a year out from your last treatment, like myself at this moment, you think less of cancer and more of other things you want to do. You have to take it a day at a time. I know it's hard but trust me it will get easier. Some days will be good days and others will be bad days. Then you will have more good days then bad. You are not alone in this battle, and we are all here to support and help each other. Please post or email if you need to vent. I wish you peace for today and every tomorrow. Hugs, Lili
  • vac
    vac Member Posts: 97
    Mine was also stage 3 I had
    Mine was also stage 3 I had 13 + lumph nodes. I went with the agressive chemo and also stem cel transplant. That was 6 years ago the transplant over 5. I feel great. Good luck Vicki
  • mimivac
    mimivac Member Posts: 2,143
    lynn1950 said:

    thank you
    Mimi, You knew just the right thing to say. Thank you for the encouraging words. Today was a better day, for no good reason at all. I wish you a hopeful day for today and tomorrow and tomorrow and tomorrow.... Lynn

    Hopeful day
    Lynn, I'm glad you had a better day. This disease gives us so many ups and downs, doesn't it? I think that's so normal. I also think that as time goes by, the ups start to outnumber the downs. Gradually maybe, but the wonderful people on this site assure me that it happens. And I believe them!

    I had a great pity party yesterday. It was the perfect storm: I have my second chemo session on Friday and my husband has to be out of town for it. The tears came out of nowhere. But today, I gave myself a break from work and made a list of nutrients that will help me heal from chemo and that have anti-cancer properties. I took care of myself, exercised, watched a funny movie, and took a bath with lavender bath foam. Just doing those things for myself made me feel more in control, calm, and happy. I don't always get there, but I know what helps. And so do you, Lynn.

    Hope you are still feeling good.

    Mimi