Triple status, ok... but what about tumor grade?

[jojo]

People tend to bring up in conversation about long-term survivors with their status (ER/PR/Her2) and the numbers of their disease-free years since original diagnoses. It is always inspiring to hear about the survivors.

But lemme tell ya what ALWAYS comes to my mind EVERY time I hear of a story: what about their tumor grade? Don't you notice that the popular trinity is always mentioned (ER/PR/Her2), but the tumor grade is RARELY mentioned??

As much as cancer can be so mystified, I am almost sure that long-term survivors mostly likely have slow-growing cancers (either affected by DNA make-up or medical treatment), in other words types of "grade 1" breast cancers. I believe there is a WORLD of difference between grade 1 & grade 3 tumors.

What do you think about the aspect of "tumor grade"??

[jojo]

FYI: To me, "long-term" means a good number of years beyond the typical 5-year window.

[Lyn]

Hi there, I don't know anymore, in 1998 I had a very agressive, fast moving, invasive as well as tumour the size of an oranage in my breast, I had a radical mastectomy, chest and pectoral muscle removed along with 16 lymphs that were all positive, I had no clear margin and I was not hormone responsive, I got my results on the 8th of the 8th, and I thought before I went in that hey 8 is my lucky number so the news should be good, wrong but maybe is lucky. I have been having reoccurences in lymph glands in the neck and skin, I was given 2-3 years at best survival. That was then, I have had over 10 different chemos, over 100 radiation session and 2 hormone drugs and been on Herceptin for over 3 years, strongly HER3+, now I am treating what appears to be another form of breast cancer in my remaining breast, before it surfaced there a new gland in my neck was biopsied and it was similar but not the same as the original, so it makes sense that my new biopsy on my remaining breast is HER 1+ - 2+, no mention of invasive and it has been lingering since January this year, I had 26doses of radiaiton with Xeloda and Carboplatin, my breast was just about cremated but still there is cancer there. I figure I have cured the left side and now have to cure the right side. So I have have survived over the 2-3 year and 5 year target and into my 7th year of treatment, eventhough I was a category III to IV, I have not had organ or bone involvement, I do believe that the Herceptin has mutated the BC cells and like your tornados been down graded. No other explanation except my cancer is obviously a chronic disease and I liken it to diabeties but too much baggage along with it. The rads interfered with my thyroid, my thyroid gave me heart failure, I also have a connective tissue disorder in the Lupus family, which means I have 2 to 1 trying to destroy me, unless they are busy fighting each other for poll position and allowing me to continue living. I also have a collapsed shoulder nothing to do with treatment but a fall and the damage went undetected for 3 months. My left ventricle has always been in the high 50's even when I was in heart failure, so the Herceptin was of no threat. Now I will find out on Tuesday which way I am going to be treated, surgery out of the question, my onc say when do you stop cutting, I have never had any more lymphs removed or further surgeries. My onc says my BC is just smouldering, and we can't get Abraxane in Australia yet, so have to make up another cocktail in the meantime to buy more time for the magic bullet. So as for staging, if anyone can work out what I am I would be pleased to know. Out of all of the patients that are HER tesded at the 2 hospitals I go to for my BC treatment I am still the only one on Herceptin.

Love & Hugs Lyn.

[Rozebud]

Jojo - I know what you mean (you're thinking of the YSC post of the 52 year survivor, right?) I ask the same questions, almost never with tumor grade though. Tumor grade is not as predictive of prognosis as other factors. Namely, staging is one of the top - lots of lymph nodes high up on the list, followed by large primary, etc. Usually what happens is that your grade follows the other stuff. There are lots of women out there who are stage 1 whether they are grade 1 or 2 or 3 and do fine.

Now, when I hear stories of women who had 20+ nodes or a 8 cm tumor with half a dozen nodes and didn't even do chemo because it wasn't around, then I'm encouraged!

[Christine OZ]

same here Rozebud.

[jojo]

Thanks for the explanation; I hadn't realized that the tumor grade was not a factor as predictive as the triple status.

[Rozebud]

Here's a long (but I think good) article I just ran across....

http://theoncologist.alphamedpress.org/cgi...nt/full/9/6/606 (http://theoncologist.alphamedpress.org/cgi/content/full/9/6/606)

It says that presence of lymph nodes is the biggest predictor, then how many, then size of tumor. That doesn't mean grade isn't a predictor, just not as big as the others. Also, I will highlight one quote from the article:

"In conclusion, tumor grade does have prognostic significance and is primarily used to make decisions for lymph node-negative patients with borderline tumor sizes. "