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Oncology (General Cancer)/What do these DCIS / breast cancer lab results mean?

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Question
My relative read the lab results over the phone to me. She was too emotional and overwhelmed in the appointment and can't remember what the doc said when it was explained. She wants me to do research, explain it to her, and come up with questions to ask at the follow-up appointment. Will you please explain this to me? Thanks for the help!

Ductal Carcinoma In Situ

Grade 2
moderately differentiated
Doctor wrote in beneath that the word intermediate

Grade 3
Poorly differentiated
Doctor wrote in beneath that the word high

Estrogen receptor - positive
Progesterone - negative
Her 2+ equivocal Neu [She was unclear when telling me this. I don't know if equivocal goes with it or if it is a separate category.]
Ki-67 Intermediate 20%

Answer
Such a situation is not uncommon. If someone is aware of his/her sensitivity to these situations it is a good idea to bring along a not too close friend (close friends, close relatives & family members should probably be avoided since they may be sensitive too to this situation) as a neutral witness and help to understand any given report and explanation.

Ductal carcinoma in situ (= ductal cancer stage 0). This is a cancer of ductal origin (in this case since it is a breast cancer from cells in a milk duct) that grows ONLY in its site of origin without any evident sign of any spread to any surrounding tiisues. This is a favourable situation since the tumor does not seem to have spread. There are different stages of a cancer depending on how much and how far it has spread. Stage 0 is of least risk while a 4 is very dangerous. In between you have of course 1,2 & 3 often with subgroups (a, b etc.) too.

Grade. Cancers have different degrees of aggressiveness and tendency of spreading. This is called grade. The higher the grade the worse it is. A grade 2 is moderately dangerous higher than 1 but lower than 3 so it can be called intermediate. A grade 3 is therefore worse still. Moderately differentiated is another way of saying grade 2 and poorly differentiated of saying grade 3. A grade 3 cancer is a high risk cancer. A grade 2 a moderate or intermidiate risk cancer and a grade 1 is a low risk cancer..
Estrogen receptor and progesteron receptor are female sex hormone receptors. Breast tissues normally have such receptors since they are hormonally controled. Some (not all) breast cancers also have them either one or the other of these receptors - as here with estrogen receptors - or both. If such receptors are present hormonal treatment may be possible. Her2 is a laboratory sign (+ means that it is present) that indicates that the tumor is extra aggressive. Special treatment is therefore necessary. What is indicated here is a special category. Your relative should contact her doctor in order to find out what treatment is planned for her. I think that it would be a good idea that you participated so it does not end up in a similar situation to the present!
Ki-67 is an index indicating the growth rate of a tumor. It is important in evaluating how dangerous a tumor is. But that is not just evaluated by this index. Several other factors - see above - must also be considered.


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Oncology (General Cancer)

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Claes-Gustaf Nordquist, M.D.

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Questions concerning Cancer, Oncology, radiation Therapy, Tumours, Chemotherapy, Cytotoxic Drugs, Hormonal Therapy, Radiation Protection.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions in the number of questions there. I also answer questions in these other categories: General History, Military History, Brain Tumors, Breast Cancer, Colon Cancer

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