To answer directly, if ANY part of the biopsy is graded as high grade, the whole is considered high according to my URO. Also, the intermediate grade for most practices has been dropped to either low grade or high.
It appears your URO is pulling all of the right levers from reducing dosage as needed to continual observation. I can't find my citation on size however, I remember that less than 2 CM is considered small. That doesn't not correlate directly to grade.
DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.
As I am some 4 months old on this forum, my case history is know to some people here. But still I will reveal my case
My father's Diagnosis:
12 Sep 2020 ---> Gross Hematuria
12 Sep 2020----> USG revealed calcified focal plague like mass in UB
12 Sep 2020 ---> CT scan revealed 1.8mm x 0.6mm focal plague in UB
13 Sep 2020 ---> Cystoscopy revealed Papillary growth in UB posterior wall and BN and part of Trigone.
14 Sep 2020 ---> TURBT for all Bladder Tumor and Uro report wrote Papillary growth near BN, Trigone and posterior wall. Took three sample during TURBT. Entire tumor, Deep Bladder muscles, and prostrate muscles. Uro wrote the size of tumor as 3-4 cm after surgery.
29 Sep 2020----> Pathology report said , 20-30% HG papillary carcinoma, lamina propria and deep muscles invasion not seen. Also no malignancy detected in prostrate. Pathology report measured 2.2x2x0.5cm tumor.
Also important thing was no Prostrate Urethra was involved in malignancy. Uro took samples of prostrate muscle for this reason to null out.
29th Sep 2020--->Uro suggested BCG 6 weeks
Till 28th Oct 2020 done with 4 BCG doses. Had to stop because of side effects.
Schedule for Cystoscopy next week with muscle sample for biopsy to null out upstaging. And after that BCG maintained with reduced dose as recommended by Uro
I want to understand which category our case is: Intermediate or High.
Thanks to all members in advance especially, Sara, Alan, Joea