For Grade 2, is a score of 6 much better than a 7?

Orangeflower: Mine was a 2 but changed to a 3. My understanding is how many cells look different from each other that makes the # change. But i could be wrong. Onco said I was between a 2 and a 3. He was reluctant to give me a 3 but as we went over everything he agreed it could be a 3. IDK Supposedly that is not an an important to him (so he says) BUT it feels important to me. I hope mentally you are feeling better. Got good news today regarding SIL. Scans look better...area on her kidney gone and lung nodule smaller. I know she doesn't have breast cancer but lymphoma is no picnic. So that's why I talk about her.

Hi,

Was just diagnosed with Breast Cancer and wondering what the grade means. I'm thinking that it's not the most important part of the cancer. Am I right?

I am copying this answer I gave from a question in another thread, but it is an explanation of how the pathologist determines grade.

Grade is comprised of three scores that range from 1-3 in categories that include 1) tubule formation, 2) pleomorphism or nuclear, and 3) mitosis. These three aspects of grade reflect three components the pathologist sees when looking at your tumor or biopsy under the microscope. It is important to note that tumors are not homogenous in that different areas of a tumor can be different grades or even have different receptors. What the pathologist sees is a cross section, but hopefully a number of those from throughout the sample to reliably say what the grade is. In many instances the findings are corroborated by another pathologist before the report is signed off, so there is confirmation of what the first one is seeing. Grade demonstrates how close to, or how far away from, normal cells the tumor material appears. The tubular score shows how well the cells are trying to form normal looking glandular material. For a score of 1 in that category greater than 75% of the cells should form glands, for a 2 score 10-75%, for a 3 less than 10%. The more glandular formation the more the tissue resembles normal cells. For the nuclear category they are looking for small normal looking nuclei and uniformity so a score of 1 most closely resembles that, a score of 2 are larger than normal with less uniformity, for a 3 the variation is more marked. Mitosis reflects how rapidly the abnormal tumor cells are proliferating. A score of 1 is less than 7 mitoses on 10 high power fields, a score of 2 is 8-15 mitoses, a score of 3 is 16 or more mitoses. Since the added scores from each category could range from 3 (all 1 scores in each category) to 9 (all 3 scores) grade breaks down as such - Grade 1 is a total score from 3-5, Grade 2 is 6-7, and Grade is 8-9. So, your total score of 6 represents the low end of Grade 2, with the strongest aspect being tubule formation, and the weakest is proliferation. There is potentially some connection between mitoses and Ki67%, which is a marker for aggressiveness, but that comparison for me personally was discordant. I feel that oncologists look at grade generally as a whole and potentially less at the individual aspects, that Her2+ and triple negative tumors are often higher grade - often Grade 3, that strongly hormone positive tumors can be somewhat lower in grade but not always. The new TNM staging system used by some physicians does take grade into consideration. It uses tumor size, nodal status, metastatic status, grade, Her2 status, and ER/PR status in calculating stage. Previously stage was determined by tumor size, nodal and mets status.