Confused with diagnosis

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Hi

I'm waiting for chemotherapy.  I just re read my diagnosis letter and I'm totally confused.

It says ' 40 mm tumour  ,Grade 2 , invasive ductal carcinoma with high grade DCIS.  5 positive lymph nodes'

Firstly I don't understand the DCIS part, I thought that was a different thing.

Secondly,  all the info I can find is that more than 4 positive lymph nodes would be Grade 3.  My oncologist was working the PREDICT results on Grade 2.

Of course I will be checking with the medical team after the weekend anyway.   However unfortunately they have made a few mistakes already with the admin side of my notes.

  • Hi  , sorry you’re at the horrible limbo stage of waiting for treatment. And also that your diagnosis wasn’t explained in person. I’m not a medic but I think I understand a couple of your queries. So my understanding is that the grade refers to the nature of the cells in the tumour. Mine was also Grade 2, and I was told that this meant that the cancer cells were less similar to normal breast cells than in a Grade 1 tumour. And that a Grade 3 tumour would have cells that were the most different to normal ones. And could be quicker growing. So Grade 2 is sort of in the middle. 
    Stage is different to Grade. It’s not referred to as much here in the UK apparently, as in the US. I listened to a Liz Oriardan short clip today about stage. She’s worth looking up generally, a breast surgeon who herself got breast cancer. I think she’s great. 
    Stage wise, you may well be right that you are Stage 3 because of the lymph nodes, I’m not sure. Liz O suggested in the clip not to get too worried about Stage as it doesn’t necessarily predict anything about treatments or survival. But of course clarify with your team if it’s worrying you. I think though that Predict uses Grade not Stage regarding putting in the information. 
    Re the DCIS, my understanding of this is that many people have a mix of invasive breast cancer (which is graded 1, 2 or 3) and ‘in situ’ (eg Ductal Carcinoma in Situ or DCIS - which I believe is classed as high or low grade but not given a number). I didn’t have any DCIS, just Grade 2 invasive, but a friend had a mix of both. 
    I hope that helps a bit and hasn’t just confused you more! I’m sure it could be better explained. Could be worth posting your queries in the Ask a Nurse section here? 
    Anyway will stop wittering and send you a hug. Xxx

    HappyFeet1 xx
    Don’t be afraid to cry. It will free your mind of sorrowful thoughts. – Hopi
  • Thank you for your reply.  I didn't realise the tumours Grade was different to the actual cancer Grade.  I will ask more info at my next face to face meeting.

  • I feel a bit of a fool and even more worried  as I thought the STAGE was 2.  I'm not sure why the medical have not even referred to the Stage at all.

  • Sorry I think I made it more complicated! It’s the Grade and the Stage that are different terms. Grade refers to the actual properties of the tumour while Stage takes in a number of factors. 
    Whilst I wouldn’t generally recommend Google searches as lots of stuff out there is out of date or just wrong, I did look up ‘stage and grade of breast cancer ‘ and Cancer Research UK has quite a good explanation, definitely better than my attempt. We are grappling with so much new terminology. Face to face is definitely the best way to get it all explained. Xx

    HappyFeet1 xx
    Don’t be afraid to cry. It will free your mind of sorrowful thoughts. – Hopi
  • I don’t think anyone ever told me my Stage. It’s definitely very confusing. It’s stuff most people never have to think about or understand…. Xx

    HappyFeet1 xx
    Don’t be afraid to cry. It will free your mind of sorrowful thoughts. – Hopi
  • No you haven't , don't worry.

    All my letters have mentioned GRADE 2   and I took that as meaning the stage.  I will check next week.  I know I've been bad googling 

    Thank you x