Help, need help reading pathology report
I got the dreaded call today, I have Cancer.
I went to the office and got a copy of my Surgical Pathology Report. I am copy and pasting. I’ve read some of the information and will continue my education. This is the third biopsy on my left breast, my sister also had breast cancer that spread.
i would appreciate any help, thanks
Left breast, needle core biopsy of focal asymmetry with associated calcifications:
- Invasive ductal carcinoma with lobular features, and ductal carcinoma in situ. See comment.
- Lobular carcinoma in situ, classic pattern, with associated microcalcifications.
CANCER CASE SUMMARY
Histologic type of invasive carcinoma: Invasive ductal carcinoma with lobular features
Size: The entire tumor size is no known. The greatest linear length of invasive carcinoma is 3 mm. Please note in-situ
carcinoma measures 6 mm in greatest extent and appears to partially involve a radial sclerosing lesion
Histopathologic grade (Modified Bloom-Richardson):
Tubular formation: Score 3
Nuclear pleomorphism: Score 2
Mitotic rate: Score 1
Overall score: Grade 2 of 3, score 6 of 9
In-situ carcinoma: Cribriform pattern DCIS is present
Nuclear grade of DCIS: Grade 2 (intermediate)
Necrosis in DCIS: Present, central
Note: Classic pattern lobular carcinoma in situ is also present
Microcalcifications: Present in CIS and sclerosing adenosis
Lymphovascular invasion: Not identified
Fixation between 6 and 72 hours: Yes
Immunoperoxidase stains are performed, with appropriate controls (block A1). The invasive carcinoma and DCIS have
strong membraneous expression of p120 and e-cadherin. The LCIS has loss of e-cadherin and cytoplasmic expression
of p120.
Pursuant with our Quality Assurance Program, Dr. Osama Tawfik has reviewed this case in intradepartmental
consultation, and concurs with the above diagnosis.
BREAST BIOMARKER RESULTS
Block Tested: A1
Cold ischemic time < 1 hour: Yes
Fixation time between 6 - 72 hours: Yes
Estrogen Receptor (ER) Status: Positive
Percentage of cells with nuclear positivity: 95%
Average intensity of staining: Strong
Progesterone Receptor (PR) Status: Positive
Percentage of cells with nuclear positivity: 5%
Average intensity of staining: Weak
Comments
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Suzzflwr, check out "getting your pathology report" on breastcancer.org (the main site here) for help in understanding your pathology report. I found it very helpful when I was diagnosed, especially since I could absorb the results bit by bit as I was ready.
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I think this is the section of breastcancer.org Beaverntx is referring to:
https://www.breastcancer.org/symptoms/diagnosis
I don't know anything about lobular features, so I cannot help you with that. However, it looks like for the invasive ductal carcinoma (IDC), it is quite small at 3mm, according to what the biopsy could measure. Now imagine the size of a peppercorn. It's about 5mm. So a 3mm tumor is quite small. The ductal carcinoma in situ (DCIS) is pre-cancerous, and the measure was 6mm. Still very small, and it's not at all unusual to have DCIS with IDC. The grade they show is 2 on a scale of 1 to 3. 3 is most aggressive, so yours is considered intermediate, medium aggressive. They measure the estrogen and progesterone reaction as ER+ and PR+.
The link above should help you with some of this, and the search function on this forum can help you find more. I'm sorry you're here, but this is a good place to get some of the information you'll need to understand your diagnosis and treatment options.
If anyone following up has corrections to what I've said, please feel free.
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thanks for the information, I printed it out. I will go over it
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Suzzflwr, sorry you find yourself here but you have definitely come to the right place. It does take a bit to begin to understand the medical terminology. It is a steep learning curve at first and we all have experienced that. I hope you will read the wonderful links MountianMia and Beaverntx suggested they will be very helpful. In reading through your report they also note that there is no evidence of lymphovascular invasion, which is another good indication along with the small size.
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I just want to send support Suzzflwr!!!
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Suzzflwr, hello & welcome. I'm sorry you find yourself here... but you came to the right place for support.
I'm not experienced with LCIS myself, so unfortunately I can only comment on what popped out at me on your biopsy pathogical report. Your upcoming MRI & final pathology will give more info. So far, as others said, it's very SMALL & this is "good" and likely early stage. Pleomorphism average. The most important prognostics follow:
Mitotic rate is LOW, so that's "excellent" and less likely to spread in early stages
LVI: not present, which is "excellent" but final post-surgical path will give better indication
ER is high at 95%, which is "excellent", but the lesser important PR is super low at 5% (more typical in younger patients)
From reading your preliminary path results, please don't worry you'll find yourself in the exact same boat as your dear sister. Everyone is different, even siblings. Wishing the best..
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Dear Suzzflwr,
We are so sorry that you received a cancer diagnosis. You have already established supportive connections here in the community and we are so glad that you reached out to join us here. Please be sure to also message us if we can lend any help. We are all here for you.
The Mods
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Hi . Sorry you had to join. Just wanted to say I also had a mixed tumor and while it is a common finding, it doesn't change anything regarding treatment plans. There is not much to find in the way of prognosis either. Most info I have found shows mixed tumors have better overall stats compared to lobular cancers, but maybe not as good a chance of getting a 2nd primary. Mixed tumors usually are lower grade (1 or 2). This is from 2013 though, so it's older information. I wouldn't be surprised if one day they do make this another sub-type (IDC-L). There was also DCIS (cancer side) and LCIS (on other breast) found with mine.
My younger sister is also a bc patient. Hers is lobular (ILC) and it has spread to her bone in a few spots.
We are both doing well, just felt compelled to say hello, wish you well, and let you know there are others out here in very similar situations and having had a similar pathology.
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Thanks everyone for your kind responses, it is greatly appreciated. Yesterday was a whirlwind, I feel better today.
PA, it’s nice to find someone with similar findings.I’m leaning to lumpectomy wit Rads. I’m 66 years old and it takes longer to heal now. If I may ask what did you decide to do for treatment.
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