[Becky]

Michelle is right about grade but there are more things to consider. When scoring cancer, the grade can be the composite of 3 features of your tumor. The histologic grade, the nuclear grade and the mitotic grade. Each of these features is given a score from 1 (low) to 3 (high) and then these 3 scores are added up for a final grade where the lowest score is 3 and the highest score is 9.

Histology is if the cells are tubular or not with tubular being a 1 and practically no tubes is 3. Nuclear grade is how the cells look compared to normal cells with looking alot like normal cells as a 1 and very abnormal looking as 3. The mitotic score is like the Ki 67. Are the cells reproducing slowly then its a 1 or rapidly a 3. Naturally the score "2" is intermediate.

So, what if you score a 1 on histology and nuclear grade but your cancer rapidly divides? You score a 5 (intermediate or grade 2) but is it the same grade 2 if you scored a 2 on histology and nuclear and a 1 on mitotic? Probably not. However, lower scores are better in general. I too am a grade 2 with histology a 3, nuclear a 2 and very, very weirdly - mitotic grade a 1 (I had my pathology redone at Sloan because of this as it is very odd for Her2 to not divide rapidly.

I hope this helps somewhat.