Biopsy shows high-grade histology with invasion but no metastasis. How is the cancer best described in terms of grade and stage?

• A. Low grade, high stage
• B. Low grade, low stage
• C. High grade, high stage
• D. High grade, low stage

Answer: (D)

Grading and staging describe different aspects of cancer. Grading looks at how abnormal the tumor cells are and how aggressively they appear to behave; a high-grade tumor is poorly differentiated and tends to be more aggressive. Staging, on the other hand, measures how far the cancer has spread in the body. If there is invasion into adjacent tissues but no metastasis to lymph nodes or distant sites, the disease has not disseminated, so it is considered low stage. Therefore, a tumor that is high-grade histologically but has no metastasis is best described as high grade, low stage.