Does all DCIS start at Grade 1?

sunny1157

I was diagnosed with DCIS, grade 3, in August after my yearly mammogram showed calcifications and I had a stereotactic biopsy.  On September 8 I had a lumpectomy and sentinel node biopsy (clear).  The did the SAVI radiation in the end of September.  Since my DCIS was ERpositive, I started on Taxmifen a week ago. 

Lately, I've been wondering if all DCIS starts at grade 1 and progresses to grade 3.  Or does it just start at grade 3?  Do any of you know?   This may have been discussed here before, but I couldn't find it.  This board is a wealth of knowledge though!

geebung

Hi Sunny,

All breast cancers are either grade 1, 2 or 3 - including DCIS. As you are probably aware, grade 1 is slow growing and is not very different to normal breast cells, grade 2 is faster growing and more abnormal and grade 3 is aggressive and fast and the cells have become very abnormal. 

I had grades 2 and 3 so I expect you could have all three grades present at once. The risk of microinvasion is higher with grade 3.

Stay well,

Jane 

cinnamonsmiles

That is a very good question to ask your oncologist!! I am curious too.

CTMOM1234

No, not all dcis begins as grade 1. Nor does it have to be grade 3 before it evolves into idc. Also, you can have more than one grade of dcis and/or idc present in the same breast.

mgm1953

Hmm good question. My mamm showed a DCIS  mix of intermediate and high grade, and this all appeared since my last mamm around a year ago. Did it just start off this way? Was it undetectable as low grade? Yet the docs say this has been growing for years, and it grows slowly. Are they just telling us this so we wait a month or more for surgery?

They know so little, really.

sunny1157

mgm1953,

Yours sounds exactly like mine. My final pathology report states "Ductal carcinoma in situ (DCIS), 0.7 cm (largest focus) comedo and cribriforum paterns, intermediate to high nuclear grade with necosis."  I am too wondering if it just started this way, within the year, or if it had been there for years and just wasn't able to be detected on my mammogram.  My BS showed me this year's mammo in comparison to last year's and I could see the difference after she told me what to look for.  The calcifications were definitely not there last year.  

sweatyspice

As I understand it, the grade does not change.   Grade 1 may go on to become invasive Grade 1, just as Grade 3 which (more quickly) goes on to become invasive Grade 3.  And you can have a mix of grades.

tarry

My dcis with grade 2 seems to have worked itself into a microinvasion fit, leaving 'innunerable foc' of the little terrors. It's worth taking a minute to be grateful for what it didn't do, after those years of clear mammos let it grow unimpeded.

SeptemberP

I was recently diagnosed last week with DCIS stage 0. All DCIS does not start at Grade 1.

SeptemberP

What is the different between the stage and the grade?

cycle-path

September: grades explained here.

Stages explained here.