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Grade vs Stage

You've been diagnosed with breast cancer and you hear the words grade and stage. Everyone who doesn't have cancer always ask you what stage you are...but what does that mean?

Let's break it down for you starting with the grade as that is usually what is shown first on your pathology report. Once you have a biopsy the cells will be looked at to determine if you have cancer, if so, what grade (how are the cells looking) and other factors. Other items to look for are estrogen/progesterone positive or negative and HER2 negative or positive..but let's get back to the grade.

Grade 1: The tumor cells and tissues look like healthy cells and tissue

Grade 2: The cells and tissues are somewhat abnormal

Grade 3: The cells and tissue look very abnormal

Grade 4: These undifferentiated cancers have the most abnormal looking cells

Once it is determined what grade you have more tests are done.

As mentioned above doctors want to know if it's hormone positive or not. Other scans such as bone scans, CT scans, PET scans will help determine if cancer is anywhere else in your body. Doctors will also want you to have genetic testing done to see if you have any mutations such as BRCA 1 or 2 positive or negative. This can also help determine which direction of surgery to do: lumpectomy or mastectomy as well as determine your treatment plan: chemo first possibly for example.

I know for me the stage was not clear until I had my surgery and the doctors sent the tumor out and we waited for the pathology report to come back. Yes, this is a picture of my breast, the tumor is the black behind it. It was measured to be around 5.2 cm. So what stage is that?

Stage 0: pre-malignant or pre-cancer. This is what happened in my lymph nodes. I had 12 nodes taken out and 4 were pre-cancerous. The cells did not spread anywhere and we caught them in time.

Stage 1: Cancer is only in the cells where it started and is the most curable as the area is small.

Stage 2: It may be larger than stage 1 and/or spread to nearby lymph nodes. Cancer is in the organ where it started.

Stage 3: Cancer is where it started and is larger than stage 2. It may have spread to nearby lymph nodes and/or other nearby tissues or organs.

Stage 4: The cancer has spread to organs in other parts of the body aka metastasized. There may be cancer in different areas but is considered the same cancer as where it started.

Recurrent: This means it has come back after it was initially treated. It could come back in the same area or in a different part of the body.

For me I ended up being stage 3. My tumor was larger and there were precancerous cells in my lymph nodes. Therefore my treatments were more intense. Initially we thought just surgery and I would be done but since the nodes were part of it I then had to do chemo and radiation. Check out my other blogs on those topics. I hope this helps to break it down

*research from University of Rochester Medical Center

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