What Is Tumor Grade
Tumor grade is a way of classifying tumors based on certain features of their cells. Its highly related to prognosis and is part of breast cancer staging.
Using a microscope, a pathologist studies the tumor tissue removed during a biopsy and checks:
- How much the cancer cells look like normal cells
- How many of the cancer cells are in the process of dividing
Together, these factors determine the tumor grade.
What Does Stage 3 Mean
Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors.
With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.
Doctors further divide stage 3 cancer into the following stages:
What Is A Cancer Grade
A cancers grade describes how abnormal the cancer cells and tissue look under a microscope when compared to healthy cells. Cancer cells that look and organize most like healthy cells and tissue are low grade tumors. Doctors describe these cancers as being well differentiated. Lower grade cancers are typically less aggressive and have a better prognosis.
The more abnormal the cells look and organize themselves, the higher the cancers grade. Cancer cells with a high grades tend to be more aggressive. They are called poorly differentiated or undifferentiated.
Some cancers have their own system for grading tumors. Many others use a standard 1-4 grading scale.
- Grade 1: Tumor cells and tissue looks most like healthy cells and tissue. These are called well-differentiated tumors and are considered low grade.
- Grade 2: The cells and tissue are somewhat abnormal and are called moderately differentiated. These are intermediate grade tumors.
- Grade 3: Cancer cells and tissue look very abnormal. These cancers are considered poorly differentiated, since they no longer have an architectural structure or pattern. Grade 3 tumors are considered high grade.
- Grade 4: These undifferentiated cancers have the most abnormal looking cells. These are the highest grade and typically grow and spread faster than lower grade tumors.
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Category 4 Suspicious Or Indeterminate Abnormality
A BI-RADS category 4 mammogram is where concern for breast cancer risk begins to increase. Your breast cancer physician should recommend a biopsy with BI-RADS category 4. Typically, a lump is present, but does not initially appear to have the morphological characteristics of breast cancer.
Therefore, there are 3 sub-categories of BI-RADS category 4 and these are as follows:-
- BIRADS 4AThere is a low suspicion of malignancy.
- BI- RADS 4B There is a moderate suspicion of malignancy.
- BIRADS 4C There is a high suspicion of malignancy.
Findings typical of BIRADS category 4 include:
Scientists estimate that the positive predictive value of BI-RADS 4 mammograms to be around 20-40%.
|powderish microcalcifications are suggestive of BI-RADS classification of 4.|
|These powderish microcalcifications appear in large clusters.|
Invasive Ductal Carcinoma Stages
Invasive ductal carcinoma stages provide physicians with a uniform way to describe how far a patients cancer may have spread beyond its original location in a milk duct. This information can be helpful when evaluating treatment options, but it is not a prognostic indicator in and of itself. Many factors can influence a patients outcome, so the best source of information for understanding a breast cancer prognosis is always a physician who is familiar with the patients case.
In general, breast cancer stages are established based on three key variables: the size of a tumor, the extent of lymph node involvement and whether the cancer has spread to other areas of the body. This information may be obtained through a combination of clinical examinations, imaging studies, blood tests, lymph node removal and tissue samples . If, based on the initial test results, a physician believes that the cancer may have spread to other parts of the body, further testing may be ordered, such as a bone scan, positron emission tomography scan or liver function test.
Invasive ductal carcinoma is usually described through a numeric scale ranging from 1 to 4 . Specifically, the invasive ductal carcinoma stages are:
If youd like to learn more about invasive ductal carcinoma stages and treatment options, call or complete a new patient registration form online.
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Determining The True Stage Of Breast Cancer
All the diagnostic tests and scans up to this point have been critical for helping your doctors understand your disease. But the exact stage of cancer cant be determined until surgery happens which is sometimes referred to surgical staging or pathological staging.
Breast surgery is usually the first step in Stages 0-2, and sometimes Stage 3 breast cancer. Surgery allows your surgeon to see whats happening inside your body. It also allows them to remove cancerous tissues which is an important step in preventing the cancer from spreading and determining next steps for your treatment.
If surgery cant be done right away or at all, a clinical stage is given instead based on diagnostic imaging test results, biopsy pathology results, and a physical exam.
Staging And Grading For Stage 3 Cancer
Staging is an important factor in determining cancer treatment options, since it establishes the tumors size and spread within the body. Staging is used for most cancers, but not all. Cancers in and near the brain, for example, dont use a defined staging system because their likelihood of spreading is low.
In general, cancer falls within stages 1 through 4. Some types may be stage 0, meaning there are cancerous cells in a layer of tissue, but they havent grown or spread.
Most cancers are staged using some form of the TNM system. Doctors may also use the TNM system to help determine the extent of certain cancers in each stage. The TNM system stands for:
- T , for the size of the original tumor
- N , whether the cancer is present in the lymph nodes
- M , whether the cancer has spread to other parts of the body
Some cancers, especially liquid cancers, are staged using different established protocols. The Binet and Rai systems, for example, are used to stage certain types of leukemia. Cancers of the female reproductive system, such as cervical cancer and ovarian cancer, are staged using the FIGO staging system, designed by the International Federation of Gynecology and Obstetrics .
Regardless of the system used, the first step for doctors staging cancer is to gather information about it. Some tests or procedures that may be involved as your care team is staging your cancer include:
When it comes to grading, tumors generally may be referenced in the following ways.
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Hi Spinnr1 Sorry About Your
HI Spinnr1, Sorry about your friend. Looks like she has a good friend in you. I also have infiltrating Ductal Carcinoma. I can tell you, that you need to wait for more information. Some of this will come when she goes to the doctor. Make a list of questions or you will forget. I think there is some information right here on Questions to ask your doctor. Cancer always comes out of left field. The level is not the stage. She won’t get her stage until after surgery. I am sure you will get a lot more information here than I can provide. Again so sorry for you and your friend, take care
wow…I can’t believe that they would tell her that on the phone with no explanation of what it means….and make her wait so long for a consult…my surgeon sat me in front of a big white board and drew everything out for meand then gave me a photo of the board to refer to. The thing is that there are so many variables that just going online and looking up what they told her wont really tell her much. That is a long time to make her wait for an explanation….I believe I’d be looking for a new Doc. Is she going to a breast cancer clinic ? They usually understand how important it is to not make us wait for answers.
What Is Stage 3 Cancer
Stage 3 cancer is sometimes referred to as locally advanced cancer. In this stage, the tumor may have grown to a specific size, the cancer may consist of multiple tumors, and/or the cancer may have spread to adjacent lymph nodes, organs or tissue. In some cases, stage 3 cancers may be considered metastatic cancers, meaning they may have spread beyond their organ of origin.
Many stage 3 cancers have multiple subcategories, usually designated as stages 3A, 3B and 3C. These subcategories are often determined by the size of the tumors, whether multiple tumors are present and the degree to which the cancer has spread locally.
Liquid cancers, or blood cancers, such as leukemia, lymphoma or multiple myeloma, are staged differently than most other cancers because they may not always form solid tumors. Liquid cancers may be staged by a variety of factors, including:
- The ratio of healthy blood cells to cancerous cells
- Whether cancer cells are found in lymph nodes or the diaphragm
- The degree to which lymph nodes, the liver or spleen may be swollen
Stage 3 cancer is determined in the five most common cancers this way:
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The Effects Of Breast Cancer On The Body
At first, breast cancer affects the breast area only. You may notice changes in your breasts themselves. Other symptoms arent so obvious until you detect them during a self-exam.
Sometimes your doctor may also see breast cancer tumors on a mammogram or other imaging machine before you notice symptoms.
Like other cancers, breast cancer is broken down into stages. Stage 0 is the earliest stage with the fewest noticeable symptoms. Stage 4 indicates the cancer has spread to other parts of the body.
If breast cancer spreads to other parts of the body, it may cause symptoms in those particular areas, too. Affected areas may include the:
The early effects of breast cancer can depend on the exact type of breast cancer you have.
Treatment Options For Stage 3 Cancer
In general, regimens for stage 3 cancers typically start with either surgery or treatment to shrink the tumor before surgery, such as chemotherapy, radiation, or a combination of both.
Stage 3 breast cancer treatment: The first step is typically either chemotherapy or surgery.
Called neoadjuvant chemotherapy, because its given before other treatment, this may help shrink a tumor enough that breast-conserving surgery is possible. If it doesnt shrink enough, the patient may need a mastectomy instead. HER2-positive cancers may also be treated with targeted drugs before surgery.
After surgery, depending on the type of breast cancer, your treatment may continue with radiation. Chemotherapy and/or targeted drugs may be part of your treatment plan after surgery as well.
Stage 3 lung cancer treatment: This is highly dependent on how large the tumor is and which lymph nodes are affected. Generally, treatment begins with chemotherapy and/or radiation. You may have chemotherapy and radiation at the same time, or you may have them one after another. Surgery may follow this treatment if your care team thinks the remaining cancer may be successfully removed. After surgery, additional chemotherapy and/or radiation may be part of your treatment plan.
If chemotherapy, radiation or surgery arent appropriate options, immunotherapy drugs may be.
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What Is The Life Expectancy For Stage 3 Breast Cancer
The life expectancy for people with breast cancer is improving, according to the American Cancer Society. It points out that current survival rates are based on people who were diagnosed and treated at least 5 years ago and treatments have advanced over that time.
Your life expectancy with stage 3 breast cancer depends on several factors, such as:
- your age
- the size of the tumors
You should talk with your doctor about how these factors may apply to you.
Category 5 Highly Suggestive Of Malignancy
Doctors assign a category 5 BI-RADS when there is a very high probability of breast cancer. So, your medical advisor will request an immediate biopsy.
Findings typical of category five include:
BI-RADS category 5 is usually reserved for lesions having a 95% probability of malignancy. After biopsy the average rate of carcinoma in category 5 biopsies is about 75-97%.
|Casting microcalcifications appear linear, fragmented, and branching.|
|In this image the casting microcalcifications are branched, and granular.|
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Breast Cancer Staging Guidelines
The TNM system is the most widely used cancer staging system and looks at the following cancer characteristics:
- Tumor The size of the tumor and whether it has grown into nearby tissue.
- Node Whether the cancer has spread to nearby lymph nodes. And if so, how many.
- Metastasis Indicates whether the cancer has spread to distant organs, like the lungs or liver.
But when it comes to breast cancer staging, the TNM system was expanded to include additional cancer characteristics, including:
- Estrogen-receptor status or progesterone-receptor status Whether the cancer has estrogen or progesterone receptors. A positive status means the cancer can use either hormone to grow.
- HER2 status Whether the cancer produces HER2, a protein that promotes the growth of cancer cells.
- Grade Indicates how much the cancer cells look like healthy cells.
- Oncotype DX recurrence score Indicates how likely a group of genes may respond to treatment, depending on ER, PR and HER2 status.
Cancer Spread In The Lymph Nodes
Sometimes doctors aren’t sure if a cancer has spread to another part of the body or not. So they look for cancer cells in the lymph nodes near the cancer.
Cancer cells in these nodes is a sign that the cancer has started to spread. This is often called having positive lymph nodes. It means that the cells have broken away from the original cancer and got trapped in the lymph nodes. But it isn’t always possible to tell if they have gone anywhere else.
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What Is A Cancer Stage
While a grade describes the appearance of cancer cells and tissue, a cancers stage explains how large the primary tumor is and how far the cancer has spread in the patients body.
There are several different staging systems. Many of these have been created for specific kinds of cancers. Others can be used to describe several types of cancer.
More Benefits Of The Birads Classification System
Another benefit of BIRADS to radiologists, that has indirectly benefited everyone else, is that the categorization scheme has helped to standardize the words used in mammographic reporting, and this has reduced the confusion and improved communication between radiologists, patients and physicians.
BI-RADS classifications have also helped in monitoring breast cancer treatment and supporting breast cancer research again by making statistics easier to calculate.
Following mammogram, a woman will usually see the BI-RADS assessment on the pathology report. So, if you do come across these terms in your report it may be useful to know what they mean.
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Why Staging Is Important
Staging is important because it helps your treatment team to know which treatments you need.
Doctors may recommend a local treatment, such as surgery or radiotherapy if your cancer is just in one place. This could be enough to get rid of the cancer completely. A local treatment treats only an area of the body.
But you might need treatment that circulates throughout the whole body if your cancer has spread. These are called systemic treatments and include:
You can read more about the different types of cancer treatment.
Category 6 Known Cancer
a known cancer, proven by biopsy. This category is used when patients undergoing breast cancer treatment have follow-up mammograms.
For a few years after breast cancer treatment, category 6 was still in use. Since everyone already knows there is, or was cancer present, we cant use categories 0 thru 5 anymore, so category 6 is assigned. Category 6 isnt useful for accuracy
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Staging And Grading Of Breast Cancer
Knowing the stage and grade of the cancer helps your doctors plan the best treatment for you.
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Your specialist doctor needs certain information about the cancer to advise you on the best treatment for you. This includes:
- the stage of the cancer
- the grade of the cancer
- whether the cancer has receptors for hormones or a protein called HER2.
This information comes from the results of all the tests you have had, including:
- the biopsy, when the tissue was examined
- other tests that were done on the cells.
Your specialist doctor and nurse will talk to you about this. They will explain how it helps you and your doctor decide on your treatment plan.
We understand that waiting to know the stage and grade of your cancer can be a worrying time. We’re here if you need someone to talk to. You can: