Caron Keating (again)
Caron Keating (again) Recently glimpsed Gloria Hunniford’s book about her daughter, Caron Keating.
What I don’t understand is how a 12mm grade 1 cancer could turn into multiple grade 3 cancers just two years later.
Can anyone explain?
Mcgle
grade-1 mutations Cancer cells are a result of several cell mutations, and the cells can keep mutating I assume, if some remain lurking after the primary treatment is complete. That’s why DCIS will often progress to IDC if not caught early enough. Grade 1 can thus mutate into grade 2 or grade 3, if you are unlucky. Caron’s case certainly seems to prove how unpredictable cancer can be.
My understanding is that breast cancer grades don’t progressively muttate from 1 to 2 to 3. There’s a huge debate I know about low and high grade DCIS, but again I think its not straightforward progression. Any biologists illuminate more?
I think Gloria Hunniford’s book is very misleading and unclear about the actual chronology and pathology of Caron Keating’s cancer and this is annoyting, and potentially alarmist and frightening for anyone wanting a realistic factual account. I think this is hardly surprising as Karon Keating herself was so reluctant to look at the reality of her cancer and kept lots of information about it secret.
Jane
Don’t know Not read the book (decided I didn’t want to do this at this point in time)
Read a theory (from ? someones BC nurse) that her cancer was inflammatory. If this is true the “aggression” of this type of cancer is a particular issue.
Problem is as Jane says the facts available are “limited”. The book is only a personal account rather than an informative document about what why and when.
If the clinical picture was 12mm grade 1 to multiple grade 3 in 2 years and anyone understood why, we would surely be a lot closer to understanding what the pathological process was, and nearer (???) to being able to manage the condition better than we do now.
All it does in my view is reinforce that BC is a nasty unpredictable disease that kills people and a good or a poor prognosis means actually very little as none of us know which side of a survival "line " we will fall.
Sandra
grading subject to error the grading is done by someone using a microscope and looking at the pattern of cells, how the nuclei look and how quickly the cells seem to be dividing - they then give a score out of 3 for each element. e.g. grade 1 is 3-5. It’s all done by eye using the specimen of cells they have got via a biopsy.
I should think it must be subject to error, in fact when the NHS has audited results they found that different hospitals have much bigger numbers of some grades than others. So there must be room for error.
Dr Susan Love says latest thinking is that low grade DCIS progresses to low grade cancer, at least that’s what the 3rd edition of her book says, high grade DCIS progresses to high grade cancer etc.
Cancer doesn’t follow the rule book is my feeling, and doctors aren’t infallible. I was thinking recently that they base their odds on what they diagnose you with initially. Maybe it is better to assume the worst despite the odds of recurrence you are quoted. If they wrongly think the grade is lower than it is, you would benefit more from tamoxifen etc than they tell you
Mole
Thank you, ladies¦ ¦ for your considered replies. I have learned so much from this site, sometimes good, sometimes bad, but always honest.
As has been mentioned many times before, we all have to live with the uncertainty of remaining disease-free. I feel that the ground beneath my feet has been removed since discovering I am HER2+ (albeit it just), but there is nothing that can be done about it at this stage.
All that any of us can do is wait and see¦
Mcgle
Caron Keating I haven’t read all of the Caron Keating book but I did have 2 friends who’s bc mutated in the way described.
I think grades can progress My first tumour was grade 1 (and I was told was very much at the benign end of the spectrum) whereas my recurrence was grade 2. I did some research which indicated that cells which manage to survive initial treatment and eventually grow into new tumours are likely to be the more aggressive ones, giving a higher grade in the new tumour. It also seems that recurrences can be more likely to spread, probably for the same reason.
Kathy
For Kathy Just wanted to commiserate with you about your recurrence, especially since the first time around, things looked so promising!
Just goes to show what a bu**er this beast is…
Mcgle
Karon’s alternative doc I read a peice in the paper by one of the alternative/complimentary practitioners that Karon saw - he said that when he examined her, her nipple was inverted and the breast swollen - this sounded like IBC to me. I know of a number of women who’ve had a new IBC primary after a previous diagnosis of a lower grade .
I suppose it’s useless to speculate, and if the family wish to keep these details private or vague - that’s for them to decide.
Thanks for that, Jane We’ll never know, it’s just so sad that she died at such a young age.
Mcgle
mistakes do happen had my mammogram and dx 16th dec.After lab reports was told tumour was very slow growing and had been there a very long time.It was 1cm.A week after my surgery on 16th jan was told it was 2.4cm was very agressive and had spread to my lymphnodes! when I complained was told “mistakes do happen”