Is my pathology report correct?

A year after intial dx I decided to study my pathology report again and am confused!

I was dx with invasive ductal cancer and high grade DCIS. The IDC tumour measured 6mm (not cm) and the DCIS was 21mm (again not cm). A CT scan was completely clear.

My path report states Grade 2 but also T3, P3 and M1. I understand from books I have read and internet sites that T3 stands for tumours over 5cm (mine weren’t) and that M1 indicates mets in distant organs (my scan was clear!).

There was no evidence of vascular invasion and I am ER+, HER-.
Level 2 aux clearance removed 11 nodes all of which were negative.

Can anyone explain the T3 and M1 please?

many thanks
Love Gill x

Hi Gill
It does sound a bit odd. T3 does usually mean tumours in excess of 5cm - even if they added yours together you are still not T3!
And M1 does normally refer to distant mets - although I have known women get a path report of M1 for multifocal tumours.
What does “P3” refer to? I have only seen TNM - tumour, nodes and mets, never P.
I think you should call your BCN tomorrow and try to get to the bottom of this.
Good luck - can you please let us know what P3 means if you find out!

I think the TNM are how the Stage of cancer is described. T stands for tumour, N for node involvement and M for metastises. The grade is decided on by using TPN. The cells are looked at under a microscope and three categories are assessed. Each category is scored 1, 2 or 3. If you score 8 or 9 you are classed as Grade 3. The categories are as follows but I don’t understand the categories very well;-
Tubule Formation (% of Carcinoma Composed of Tubular Structures) Score
> 75% 1
10-75% 2
less than 10% 3 TPM
Nuclear Pleomorphism (Change in Cells) Score
Small, uniform cells 1
Moderate increase in size and variation 2 2
Marked variation 3
Mitosis Count (Cell Division) Score
Up to 7 1
8 to 14 2
15 or more
Therefore, you scored 3 in the first 2 categories and 1 in the last category a total of 7 which is Grade 2

The important thing is YOU DO NOT HAVE METASTASIS which is why the scan was clear.

Hope this has set your mind at rest.
Regards #Kelley

A-ha … nice one Kelley!

Thank you msmolly and Kelley.

I will try and find out what P3 stands for msmolly.

I understand how the grading is assessed but your explanation makes it very clear thanks Kelley! Still unsure about the T3 and M1 bits though!

Will have to ask at annual check-up next month.

Love Gill x

My understanding of it is that:-

Tubule Formation = T
Nuclear Pleomorphism = P
Mitosis Count = M

I can’t remember what they actually mean but they’re all something to do with the “behaviour” of the cells. One refers to how quickly the cells die,(possibly M), I think one is something to do with how quickly the cells grow(maybe M) and I think the other is how different the cells look compared to ordinary cells(T).I’m possibly completely wrong.