Is a recurrence always the same grade?

I've seen people post that there recurrence was a completely different type.  Like original was ER+ and recurrence was triple negative.  So my best guess to your question is "no". 

I was diagnosed with IDC in April. I had a lumpectomy, and and axillary dissection because they found cancer in 3 lymph nodes. I started chemo in April and had 6 round. I completed chemo august 25th. I was getting ready to start radiation last week and requested that my radiation oncologist order an MRI to make sure my margins were clear before we start radiation. She first ordered a baseline mammo after surgery, that came back clean. I then had an MRI a few days later and it showed an 8mm area of concern. She ordered an ultrasound guided biopsy. They were not able to see anything with ultrasound so they recommended an MRI guided biopsy. I received the result it showed DCIS (precancerous cells). This is a new site in the same breast. I have an appt with my onco next week to discuss a lumpectomy vs a mastectomy. I am very upset that I had 6 rounds of chemo to kill any precancerous cells that might be floating around, and 4 wks after chemo we find that somehow these cells managed to survive. so to answer your question, no. I cannot seem to be able to make sense of recurrence and type, but even my oncologist is not able to give me any straight answers because truly I don't even think they know the how, why, and when of cancer. Good luck to you.

etherize, it's my very simplistic understanding that if cancer cells survive tx or for any reason start to grow again, they have the ability to adapt (mutate) to outsmart the chemo drugs that were already used on them.  So, yes, it's entirely possible for a new or recurrent bc to have a different grade and/or hormone profile.  

There's a brand new study out of Europe (posted elsewhere on BCO) spotlighting the need to always do pathologies on new lesions, and not just assume they're the same as previous ones.  Let me know if you'd like me to find a link to it for you.

So sorry you're dealing with this concern ~      Deanna 

It is not always the same grade. Sometimes ER+ will turn -, so it will need re bx.