Grade 1 tubular with high Grade dais and invasive

Hi there, hoping someone can help me please.  I was diagnosied with tubular cancer and also invasive, 2 lumps in my left breast. I underwent left wide local excision and sentinel lymph node biopsy. results showed Grade l tubular cancer with high Grade DCIS. the invasive component is 7mm and total size 35mms including DCIS.  It states the infra medical margins are positive, could you explain what that means please.  Vascular invasion is negative, sentinel lymph node biopsy negative. tumour is ER positive with HER2 still pending and I will find out tomorrow those results.  it also says NPI is 2.14 as thing stand at present, could this NPI be explained as well please.  I have since been in again and had infra medical cavity shave since they did not get all the cancer out. 

So until I go to my appointment tomorrow would like to put my husband’s mind at rest and let him know what it all means.  thank you Jules

Hi Jules,

This sounds like something our Helpline may be able to help with.  You could give them a call on 0808 800 6000.  Opening times are 9-5 on weekdays and 10-2 on Saturdays.  Calls are free and confidential.

Very best wishes


BCC Moderator

Hi jules

They use the the invasive measurements for working out your NPI which stands for nottingham prognostic index… Its a bit outdated and nowadays and isnt used so much as it doesnt look at things like her 2 status when working out the score.

Tubular cancer however is one of the better ones (if you can actually have such a thing!) but its nearly always grade one and very slow growing and rarely spreads beyond the breast so normally has an excellent prognosis… A score under 2.4 is in the excellent outcome.

The inframedial margins pribably refers to the fact you had to have the cavity shave to remove the cells… The margins usually need to be clear of invasive cancer and DCIS where possible and about 1 in 5 people having a WLE need a second op to get them clear.

Good luck with your appt