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rachael67 posted:
You may not be able to teach an old dog new tricks, but maybe you can assist an "oldie" on this board! After so many years one might think I'd not be confused on simple terms...However, you (and I) would be wrong!!

Just recently I came across an article concerning the benefits of digital vs film mammography. In it they spoke of "low grade DCIS" as compared to vs "high grade DCIS"...Okay! Now I am confused as in my reports I am given a nuclear grade but not a high or low! And now I wonder if they even are the same thing!!

(DEAR GOD, WHERE ARE OUR EXPERTS WHEN WE NEED THEM???)

Anyone knowledgeable in this area and who can answer?? Thanks, Gang!

Blessings.
Rachael
Just when the caterpillar thought her world was over, she became a butterfly! Don't give up five minutes before the miracle!!
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judyfams responded:
Rachael,
DCIS is assigned a grade based on how abnormal the cells appear and behave when compared to normal healthy breast tissue cells.
The lower the grade number the more normal the cancer cells appear and the more slowly they grow and less likely to spread. High grade have very few normal appearing cells, which tend to grow fast and are more likely to spread.
There are 3 grades - low grade is #1, moderate is #2 and high grade is #3.
Hope this clears things up for you so you won't lose any more sleep over this!!!!
Judy
 
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rachael67 replied to judyfams's response:
Judy, thanks so much for responding...Tho' I must admit, I thought I might hear from you...at least I was hoping so!

I kinda know what you are speaking about, but my confusion comes from the difference between nuclear grade and hystolic grade...Or are they the same?

Also is the possibility of future "invasive" growths based on the original diagnosis of grade or does surgery alter those odds?

I'll raise these questions at my next mammogram but that isn't until June next year, and I'm not sure I can fully relax being in limbo for that much time.

(Let me say I am not really worried but am confused...However, that is often my condition! )

Thanks again!
Rachael
Just when the caterpillar thought her world was over, she became a butterfly! Don't give up five minutes before the miracle!!
 
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judyfams replied to rachael67's response:
Rachael,
Did more research and have found some more info for you.
The nuclear grade refers to the size and shape of the nucleus in the tumor cells and the percentage of tumor cells that are dividing.
The histologic grade refers to how much the tumor cells resemble the normal cells.
The higher the nuclear grade and the higher the histologic grade (usually numbered from 1-3 with #3 being the highest grade), the greater is the percent chance of recurrence.
DCIS is more likely to experience an invasive recurrence after 5 yrs. if there is a high nuclear grade vs. a lesser % recurrence if the nuclear grade is low.
The pathology is confirmed at the time of surgery, and having the surgery does not alter the pathology, but the nuclear grade is used to determine whether or not other types of treatment would be recommended.
So to answer your question future invasive recurrence is related to the nuclear grade. The % of invasice recurrence is not that high. A study done in 2003, showed that high nuclear grade DCIS 5 yr. risk of invasive recurrence ia around 11% as compared to 5% for women with low nuclear grade DCIS.My guess is that those numbers are much lower now - since that study was done neasrly 10 yrs. ago!
Hope you enjoy the rest of the weekend.
Judy
 
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brcansur replied to judyfams's response:
Judy,
I know Rachael asked this question but I knew nothing about this and it is very interesting to know. I am satge 3 triple neg so now I am going to look at my test results and see what this may mean for me. But no I am not going to stress over it because I look at it this way I could step out my door tomoroow and get hit by a bus I just don't know so I am going to live my live to the fullest now. That is how I have always been even before my dx. Life is to short to worry all the time but I never heard of this before reading your post. Thank you again for doing the work and research to get some answers as always Have a great day angel hugs Roberta,
Roberta
 
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judyfams replied to brcansur's response:
Roberta,
My research was specifically for DCIS breast cancer. I am sure that nuclear grade is also important for determining what treatments are best for other estrogen positive breast cancers too.
However, triple negative is a non estrogen cancer and is always treated agressively with chemo, so the nuclear grade for TN is not as significant as it is for the estrogen positive cancers.
As always your attitude is so great and your posts so positive to read and I am so glad that you are doing well!
Good luck and stay away from streets that have busses!!!!!!!!!!
Judy
 
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brcansur replied to judyfams's response:
Judy,
Thank you so much for your reply you made me laugh with your remark " stay away from streets that have buses "" love it !! I will do my best as always with my chin up and a smile on my face. I knew you would notice a little remark like that because you are the researcher and notice everything lol.lol. But didn't think you would remark on it my bad you did lol.lol. All the best to you and may you have a great week ahead angel hugs Roberta,
Roberta
 
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rachael67 replied to judyfams's response:
Thanks again for doing the homework!

I have found two different references to the numbering of grade: One does give just what you found of 1-3...The other went higher than 3.

Also, as I sought 2nd (and more ) opinions and the 2nd being from an institution of great note, I am even more confused in looking back with regard to the grades as well as the size! (Guess at the time I was too overwhelmed to note the disparity! ) My initial diagnosis from the hospital and medical team who did most of the treatments and surgeries was a nuclear grade of 2 and a size of 1.5cm. The other facility, after examining my reports forwarded to them from the first, states a grade of 3 ("high nuclear grade") and a size of 2-2.5 cm. So, in trying to seek one answer, I found two more questions!!

However, as I said, I am not really worrying too much...I am selective in my worries as I have a growing list and am forced to limit new ones! So, in order to get a better picture, I will have my doctor review all my original records from them when I see her next year as well as this second place and see what she says. Given that all of this took place in 2003 and that I had a lumpectomy followed by rads and despite the fact I refused anti-hormone tx, I kinda find it less disconcerting than I might have many years back.

Thanks again for all your efforts for me! They are greatly appreciated!!
Rachael
Just when the caterpillar thought her world was over, she became a butterfly! Don't give up five minutes before the miracle!!
 
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rachael67 replied to rachael67's response:
That sentence should read: "I have found two different references to the numbering and grade..."


Sorry for any confusion!


Rachael:
Just when the caterpillar thought her world was over, she became a butterfly! Don't give up five minutes before the miracle!!
 
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judyfams replied to rachael67's response:
Rachael,
You should also take into consideration that "they" keep changing the numbers and definitions of stages and grades as the technology improves and they can now get more detailed info.
As you said your pathology is using the language and info available 10 yrs. ago. There is the possibility that using today's standards you would have had a different (possibly lower) nuclear grade.
I agree that you should not be too concerned at this point, but would like to know what you ultimately find out.
Judy


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