High stage, Low grade

overjoyed4life

Feeling a little down today. It is the holiday and I didnt have a cookout. I need to hear from some of my sisters. I cant seem to find any news about high stage, low grade anywhere on the net. Stage 3, grade 1. Any suggestions?

Josiekat

Hi- sorry to hear you are having one of those days. I am stage 3, grade 3, but I just wanted to say hi. Are you finished treatment and did you have a good response?

Sorry I can't be of more help.

Cheers.

Dianarose

Hi- I am stage IIIc, grade 2 and I have had the same kind of day. I am so depressed today. I worked until 2 and came home and cleaned the bathroom and did laundry. I have a major headache just thinking about starting chemo on Wednesday. I live in Maine so I wait all dam winter for summer and now I will be feeling like shit and dictated by doctor appointments. I was angry for the past week and now depressed. I wonder what emotion next week will bring. Oh ya, fear. That's the one that is next. Sorry for not being so positive. I need to get out of this rut I am in.

Did you do chemo? I see you are Arimidex though.

jacee

Well, I'm not high stage but had a 7mm tumor, grade 1, go to 3 lymph nodes. One node was an internal mammary node. Doesn't seem "least aggressive" to me. You are so right, there is very little out there about low grade, aggressive tumors. Makes me question the whole grading system.

mary625

Hi--I am stage IIIc, grade 2, too.  I would have liked to have had a cookout too today.  My 20 YO son went off to one.  Hubbie and I went to a movie.  I'm just a month from ending treatment, and it's been a hard month.  I've been down a lot because there is now time for the severity of my situation to sink in.  I'm not sure what I'm ready to do yet in terms of life decisions, and I had a situation yesterday where that came up.  Right now, I'm trying to take things step by step in recovering from treatment, but I realize that I have changed, my situation has changed and life will not be normal again.  I am trying to stay in the present.  It's hard, but it seems to help. 

TectonicShift

I'm stage 3c but grade 1.

There is actually going to be a special session about us at San Antonio this year:

     Treatment on the Edges: Discordance Between Stage and BiologyModerator: Kathy S. Albain, MD, FACPLoyola University Chicago Stritch School of MedicineMaywood, ILBad stage, but good biologyKathy S. Albain, MD, FACPLoyola University Chicago Stritch School of MedicineMaywood, ILLow stage…but adverse biologyMartine J. Piccart, MD, PhDJules Bordet InstituteBrussels, BELGIUM

I don't know whether my prognosis is better than the typical stage 3c patient because I'm grade 1, or worse than the typical grade 1 patient because I have a lot of nodes.

Or maybe it's worse than the typical stage 3c patients because I'm grade 1 and the chemo won't have worked on any circulating tumor cells or distant micro tumors.

I'm very tempted to contact Kathy Albain to see if she can tell me anything.

TectonicShift

Hi, Sherri. I was Posy1 but one day I had sort of the flash of an idea to change it to TectonicShift. I think it's because since my DX I feel I have experienced a tectonic shift in every part of my life and my mind!

MelG

Interesting topic.   I'm Stage 3 but Grade 1 too - however, my tumor's mitotic rate was high with areas of necrosis in the tumor which indicates it was fast growing.   It snuck into grade 1 by being optimal in the other two categories of, I think, similarity to "normal" breast cells and tubule formation.   It was 5 out of 9 on the scale where 3-5 is Grade 1.

Despite being 7.5cm, it was only in one lymph node though and I am coming up to 9 years since diagnosis without further incident :-)   so I guess those "good features" were indeed *good*.   I agree, though, the grading is all a bit vague.

Mel

Elizabeth1959

I would love to get a summary of the discussion re high stage, low grade.  I had a 16 cm IDC tumor with 1/17 positive lymph nodes.  Grade 2 with low oncotype dx score and exceedingly low ki67 score.  There is really no information out there re whether biology of huge tumor could give me hope for a long life.  Most data is pretty grim and/or not applicable to me since no one else has such a large tumor. 

MelG thank-you for posting your story.  You give me hope.  Obviously 16 cm tumor is different than 7.5 cm but both are large with one positive lymph node.  Again, it's great to see a long term survivor.

overjoyed4life

WoWWWWWWWW! I thought I was alone with this. Good to know I have others in the fight with me. Great to hear from the long term survivors, that truly made my spirits better. 

Thanks! 

MaxineO

I will pay attention to this link and the upcoming research.  Good to see others out there.

My BS said to me that this type of BC is unusual i.e., high stage, low grade.  When my DH asked if I would be written up in a scientific journal, he responded "not THAT unusual!"    I have heard the same as Sherri, that it was slow-growing and had probably been there a while.

TectonicShift

Ugh! Guess what I just found out? My breast tumor was originally graded at grade 1 (from punch biopsy). Then after mx they told me it was a mix of grade 1 and grade 2. So in my head I chose to continue to believe that I was grade 1 although I knew it was a mix. But a very smart onc that I saw recently for a second opinion said he wanted to try to figure out why a grade 1-2 breast tumor would spread to 11 nodes. It's unusual. So he had his path department order a clean slide of one of my node tumors so they could take a closer look. Guess what. The cancer is the node is straight grade 2!!

So even though much of my breast tumor was grade 1, it had some grade 2 in it and it was the grade 2 cancer cells that moved into my nodes and grew. Ugh. I can only hope that maybe the chemo worked better as a result.

I liked believing I was grade 1 !!!!!!!!! 

msmpatty

I was diagnosed as Stage IIB, Grade 1.  Is it possible that because Grade 1 is the most "like" normal breast tissue we aren't diagnosed as early? 

My nipple inverted five years before I was diagnosed.  During that time I had mammos, ultrasounds...nothing indicated cancer.  No one could ever feel a lump.  But by the time a mammo found it, my two sentinel nodes were involved.

Patty

TectonicShift

Okay so.... new update. 

My punch biopsy said my breast tumor was all grade 1.

After mx, they told me my breast tumor actually had both grade 1 and grade 2 in it. A mix -- with big areas that were well differentiated and indolent, but also areas that were more aggressive grade 2. The mx path report called my cancer "grade 1-2."

So I walked around feeling good that even though I was stage 3 with lots of nodes at least I was mostly grade 1.

But I recently went for a second opinion at a different hospital and the onc I saw said it's unusual for someone with a grade 1 breast tumor to go to many enlarged nodes. He wanted to take a closer look at the cancer in the nodes to see if it was a different histopathology than the cancer in the breast tumor. He said that although the breast tumor is 75% ER+ and Her2- and grade 1-2, the cancer in the nodes could be different. Could be Her2 positive. Or ER negative. Or a higher grade. And he thought it might be, since I had a lot of nodes, big tumors in the nodes, and busting out of the nodes. He said it's important to check because if the cancer in the nodes is Her2 positive or borderline Her2 positive I would likely need Herceptin.

So he got a fresh clean slide of just one of the node tumors. Lo and behold the cancer is my nodes is all grade 2 (no grade 1 at all). The ER positivity was the same and the number of Her2 receptors was slightly greater than in the breast tumor (still negative).

If you have a heterogenous breast tumor - which I guess most are to some extent - and a lot of nodes, ask your onc to ask the pathologists to take a clean slide of just one of the node tumors and run a new path report on it. After all, it's the cancer that travels from the breast to the axillary nodes that matters. You really need to know the histopathology of the node tumors moreso than the breast tumor.