What Nottingham score on N.Pleo. makes tumor pleomorphic?

stella1960
stella1960 Member Posts: 13
edited June 2014 in ILC (Invasive Lobular Carcinoma)

HI again!  I have been trying to find out what score on Nottingham nuclear pleomorphism scale qualifies a tumor as being pleomorphic. I have searched the web and found 1 article that said that a "moderate increase in size", which is a score of 2, makes tumor pleomorphic. But my pathologist said no, even tho  I do have a score of 2.

Any of you who have P.ILC  I could sure use your help. If a score of 2 is pleomorphic, I would like a good, reliable source that I can quote to my oncologist.  HELP!!!

Stella

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  • stella1960
    stella1960 Member Posts: 13
    edited September 2010

    HELP!!!!I  If anyone can help me with this question, it would sure be appreciated.  My decision to have left node dissection depends on what I find out.  Thanks.  Stella

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  • AnacortesGirl
    AnacortesGirl Member Posts: 1,758
    edited September 2010

    Stella,

    I'm not sure that I can help but here's the way I understand it.  Pleomorphic is a term used to say that something is varied in shape and size.  It can refer to the overall cell or it can refer to the nucleii.  My path reports states specifically that the cells are widely differentiated.  My grading is 3.  But I do not have a reference to how the nucleii look in either my initial biopsy or my surgical path report.  In the surgical path report they do state that it's pleomorphic.  My onc is unconcerned about the pleo issue but then again I have other issues that carry more weight against me with my stage III presentation.  So my situation is not the same as yours and therefore my post may be offbase.

    Maybe it would be better to base the decision on whether or not to dissect against your comfort level.  Can you live without a dissection and not knowing the status of the lymph nodes?  Or is that acceptable because you know that you will be under vigilance surveillance so it can always be done in the future? 

    As you have discovered, at this time there are no infallible ways to know how much cancer (if any) is present in the breast or lymph nodes short of surgery.  I know that the SNB is no longer an option for you but, even if it was, there are instances where that has given false results.

    A second opinion is also an option.

    I hope you can come to a decision that is comforting to you.  When do you have to make the final choice?

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