It is confusing, Anne!!
First, it appears that most of the cells in your samples were low grade...there may have been a few that appeared high grade, but evidently not a lot nor were there enough to oonsider it a high grade tumor.
Again, I am "surmising" that lamina propera tissue was present, and there may have been a few cells that looked suspicious in the sample, but not enough to say definitely that the tumor had progressed into this layer.
A "low grade" tumor has malignant cells, but not many of them are dividing at the time the sample was taken. A "high grade" tumor has lots of cells undergoing division ....ie, multiplying...which indicates that the tumor is growing rather more rapidly.
As you know, the problem with low grade bladder cancer is that, while it is not spreading to any extent, it comes back over and over. The bladder lining, for whatever reason, has become susceptible to becoming cancerous, and often produces more tumors. The danger, of course, is that they could become high grade or spread. Your urologist has confidence that you will return every three months for the required monitoring. (I bet you go to the dentist when you should, also)
There are different philosophies on how to treat "low grade." Just careful monitoring, usually every three months, is one. BCG is another, although it is not as effective in low grade as it is in high....rapidly dividing cells are much more susceptible. Some urologists do not use BCG until a low grade tumor has recurred several times.
I know that you are familiar with most of the above, but thought a summary...yes, very simplified....might help clarify things.
SA
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