• Will my grade and mitotic rate change after the final pathology?

    Asked by HearMeRoar on Friday, February 8, 2013

    Will my grade and mitotic rate change after the final pathology?

    So weird - found out last night it is in at least one lymph node. Initial pathology says tumor at 1.5 cm with grade 1 and mitotic rate 1. I'm praying to be stage 3 at this point. I went on stage 3 message boards on the breastcancer.org site and everyone has grade 2 or 3 cancer. Either I'm a freak, I'm not going to be stage 3 (maybe I have hope for stage 2) or the grade will change. What do you think?

    4 Answers from the Community

    4 answers
    • nancyjac's Avatar

      I think you have confused some of the terminology. Stage and grade are not the same thing. The grade refers to how well defined the tumor is and how abnormal the tumor cells look under a microscope. The mitotic rate is an estimation of how rapidly those cells are dividing. So a grade 1 tumor with a mitotic rate of 1 is well differentiated and low grade (least aggressive) and dividing very slowly. Stage on the other hand defines to what extent the cancer has spread with stage 1, being completed isolated in a single location within the primary area, stage 2 is more widely spread but is still contained within the primary area, stage 3 means it has spread to surrounding tissue such as skin or lymph nodes, and stage 4 means it has spread to remote tissue or organs. Anyone at any of these stages could have any grade of tumor and mitotic rate.

      Assuming that your final pathology with be upon removal of the tumor, the pathology report should reflect the same grade and mitotic rate. However, if the tumor is removed and there are clear margins, tumor grade and mitotic rate would no longer apply.

      over 3 years ago
    • HearMeRoar's Avatar

      Not confused but thanks just the same. Just upset it can appear low and slow yet be in the nodes.

      over 3 years ago
    • Cindy's Avatar

      Maybe, initially, I was diagnosed as stage 3 but after the final pathology came back it changed to stage 2. Initially, there was a false positive for cancer in one of my lymph nodes.

      over 3 years ago
    • nancyjac's Avatar

      Again, grade and mitotic rate refer to the primary tumor, not the spread of cancer cells outside of the tumor through the blood or lymphatic system. Blood and lymph fluid pass through the tumor and even if it is low grade and slow growing, the fluids can pick up existing cancer cells and carry them to adjoining tissue such as axillary lymph nodes.

      over 3 years ago

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