interpreting histology result

Hello Christina,

Thanks for getting in touch. My name is Megan, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

Welcome to the online community. I can see that you have joined the Breast cancer forum and do hope you have been finding the online community warm and supportive.

It was wonderful to read you have had a successful surgery and your results have shown that the tumour in its entirety has been removed.

With breast cancer diagnosis, it can be easy to confuse staging and grading as they use similar numerical groupings.

Staging refers to the size and spread, including whether it has spread from where it has started. Staging for breast cancer is grouped into stages 1 (1A and 1B), 2 (2A or 2B), 3 (3A, 3B, or 3C) and 4.

Staging is also how we often refer to how advanced a cancer is. Stage 1 and 2 breast cancers are usually called early breast cancer not advanced breast cancer.

Stage 3 breast cancer is called locally advanced breast cancer and often involves the lymph nodes.

Stage 4 is an advanced breast cancer often called secondary or metastatic breast cancer and means the breast cancer cells have been found in other areas of the body such as bones, liver, or lungs.

From the information you gave the tumour size was less than 2cm, had not spread outside of the breast and the lymph nodes taken were all clear. This to me suggests you might have had a stage 1A, early breast cancer. Although, as we do not have access to healthcare records, please clarify this with your clinical team.

The grade of a cancer describes how cancer cells look compared with normal cells under a microscope. This gives an idea of how slowly or quickly the cancer may grow. Breast cancer grades are grouped into 1, 2 and 3. Grade 3 means that the cells looked very abnormal under the microscope and usually indicates these are fast growing, sometimes referred to as aggressive.

However, as mentioned only 2mm of the 80mm removed was determined to be grade 3. You might say that the breast cancer was not advanced but a small part of it was aggressive.

The importance of knowing the stage and grade of the breast cancer helps your doctors plan the best treatment or surveillance plan for you going forward. Breast Cancer Now has more detailed information on cancer grade that also includes how the grade can affect treatment options.

If just ductal carcinoma in situ (DCIS) had been found, surgery alone may have been sufficient in treating it. But now with the understanding that a small part of the tumour was grade 3, your hospital team may suggest further preventative treatment options.

If it is appropriate to offer you further treatment, the NHS predict breast cancer tool may be useful in helping you decide which other treatments to have. This tool is only for women with an early grade breast cancer who have had surgery.

Additionally, to prepare for your upcoming appointment, you may find our information on questions to ask your healthcare team useful.

I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

Best wishes, Megan

Cancer Information Nurse Specialist 

Ref MD/IY

Thanks so much - I was definitely getting confused between grades and stages and your response has clarified things for me.