Expert: Claes-Gustaf Nordquist, M.D. - 10/23/2008

Question
QUESTION: My mom had an ultrasound on her breast and 2 lumps were found in the same
breast.  She has her biopsy in a couple days.  She told me the doctor told her it
looked like stage 4.  I'm assuming this is the precancer stage???  What does that
mean???  I know there are 5 precancer levels, but not sure what they all mean.
Can you help explain?

ANSWER: I suppose that you mean the BI RAD levels 1 to 5? That is an estimate of the probability that a breast lesion seen is malignant So it is an estimate of a probability, certainly NOT a certainty. It is based on what the lesion looks like mostly on mammography though ultrasound breast scans and maybe MRI breast scans are coming into the picure too. So this has NOTHING to do with any cancer cells. THAT can only be evaluated by pathology and cytology. Stage is also something else. Staging only exists in cancers and indicates if a cancer has spread or not. A stage 4 (worst) means that the cancer has spread to other more distant sites/organs. A BI RAD 4 indicates that the risk of a cancer is considerable. Biopsies are therefore very important in your mother's case!


---------- FOLLOW-UP ----------

QUESTION: My mom's biopsy did come back positive for breast cancer.  She has invasive
ductal breast cancer.  The doctor told my father its a "grade 3".  He said it has
nothing to do with "Stage 3" cancer, he said they were two different
meanings.   What does he mean by grade 3??  She is currently going to get
blood tests, MRI/CAT scans of her bones and other areas to make sure the
cancer hasn't spread.  After the results, the Dr. will discuss treatment plan
options.  I'm just wondering what the "grade 3" means, and am curious what
sites online I can look into to help me prepare us for this journey.
Thank you so much for your help.  I'm just trying to understand as I am 3000
miles away from my mom and can't be there for some of the Dr. appts.

Answer
Yes grade & stage are 2 different things. I have already told you what stage means. Grade is an evaluation of how malignant a cancer seems to be based on its microscopical picture. Grade goes from 1 to 3 and in some cases to 4. The higher the grade the more malignant (worse) the cancer seems to be. So a grade 3 seems to be quite malignant.