Just got my biopsy results

wamama

Hi everyone. I just got my biopsy results back in my online chart. I know they will call me tomorrow but I am struggling to interpret the results. I know it isn't good. Can anyone help me?

Tissue	Your ValueSEE BELOW		FlagA
Accession Number: VP-23-1807 Patient Name: Department of Pathology SURGICAL PATHOLOGY REPORT Pathologic Diagnosis: Breast, left, asymmetry, cores A, B, C, D, and E, core needle biopsy: Invasive ductal carcinoma, not otherwise specified (see comment). Nottingham grade = 2 of 3 (tubules - 3/3, nuclei - 2/3, mitoses - 1/3, total score 6/9). Longest linear extent: 5 mm (present in multiple core fragments). Lymphovascular invasion: Not identified. Microcalcifications: Not identified. Breast Profile % Positive Intensity Results Estrogen Receptor (1) 85 Strong Positive Progesterone Receptor (1) 95 Strong Positive MIB-1 / Ki-67 (2) 5 Internal control cells present and stain as expected Cold ischemic time: 10 minutes. Total time in formalin: 29 hours. Comment: The morphology of the ca rcinoma is infiltrative with neoplastic cells arranged in sheets and single-files in many areas, a growth pattern highly reminiscent of that of invasive lobular carcinoma. However, both the E-cadherin and p120 catenin immunohistochemical stains demonstrate diffuse membranous reactivity in the tumor cells, findings consistent with an invasive ductal carcinoma Core needle biopsies are relatively small and certain histologic characterizations of invasive carcinomas (subtype and grade) may not be representative of the entire lesion in the breast. This case has been reviewed by Dr. with concurrence. The findings in this case were also conveyed to all Breast Radiologists via secure VC e-mail on 02/15/2023. Her2 studies will be performed at an outside institution, and a separate report with the results of these tests will be issued. Footnotes: 1. Estrogen and progesterone receptor expression were determined by immunohistochemistry utili zing FDA-cleared rabbit monoclonal antibody detection systems (Ventana ER Confirm [SP1] and PR Confirm [IE2]). The ER and PR stains are considered positive if there is moderate to strong nuclear staining in at least 1% of the tumor cells by manual microscopic counting. Inadequate specimens are not reported. Invasive carcinomas with nuclear positivity for ER may be reported as a specific number or a range if more than 10%. Invasive carcinomas with 1 to 10% of cells staining for ER (not PgR) are reported as "Low Positive". 2. Tumor proliferative activity was determined by immunohistochemistry utilizing an FDA-cleared rabbit monoclonal antibody/detection system (Ventana Ki-67 Confirm [30-9]). The percentage of tumor nuclei labeling with the antibody was determined by manual microscopic counting. Reference: American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone R eceptors in Breast Cancer. Arch Pathol Lab Med 134(6):907-22. 2010. BCY:fgg ________________________________________________________________________ Clinical History: Date of Service: 02/13/2023 Left breast asymmetry with associated architectural distortion 3:00 11 cm FN. Collection date/time: 02/13/2023 / 1340. Placed in formalin date/time: 02/13/2023 / 1350. Out of formalin date/time: 02/14/2023 / 1851. Duration of fixation: 29 hours. Meets ASCO/CAP guidelines of 6-72 hours for Her2; 6-72 hours for ER/PR. Fixative type: 10% neutral buffered formalin. Cold ischemic time: 10 minutes. Gross Description: The specimen is received in one formalin-filled container labeled with the patient's name, Left breast specimen A, B, C, D, E, with asymmetry (possible residual tissue in remaining chambers: F - with asymmetry after aspiration): The specimen container is labeled "left breast specimen." Received in chambers A through F ar e five fragments of tan-pink and yellow tissue with multiple minute flecks measuring from 2.2 x 0.4 cm to 0.6 x 0.2 cm. Submitted entirely in cassettes A (three fragments) and B (two fragments) after filtration. The remaining fragments aggregate to 2.0 x 0.9 x 0.2 cm and are submitted entirely in cassette C after filtration. All cassettes are placed on the 8-hour Peloris processing protocol. VAK/KRB:fgg 02/14/2023 Microscopic Description: The microscopic examination is performed. Please see the diagnosis and comment. Immunohistochemistry: The Technical and Professional Components of the immunohistochemical stains are performed at Vancouver Clinic using appropriate positive and negative controls. All controls show appropriate reactivity. Single antibody stain procedures specific for estrogen receptors and progesterone receptors are used to report breast prognostic markers. Quantitative analysis of estrogen receptors shows staining in 85% of the neoplastic cells. Staining intensity is strong (nuclear). Quantitative analysis of progesterone receptors shows staining in 95% of the neoplastic cells. Staining intensity is strong (nuclear). A single antibody stain procedure specific for Ki-67, a proliferative marker, is used to report breast prognostic markers. Quantitative analysis of Ki-67 shows staining (nuclear) in 5% of the neoplastic cells. A single antibody stain procedure for pancytokeratin and additional single antibody stain procedures for E-cadherin and p120 catenin are performed to further evaluate the neoplasm. The pancytokeratin immunostain highlights the full extent of the carcinoma. The E-cadherin immunostain shows diffuse membranous reactivity within the tumor cells. Likewise, the p120 catenin stain shows diffuse membranous staining. The latter findings are consistent with a ductal carcinoma.

jojo0529

the 1/3 mitosis is great. No lvi is also good. No one wants to be in the club but you definitely have some good things on your report

melbo

it sounds like you might have invasive ductal with lobular features, or maybe invasive lobular with ductal features — but essentially a cancer that kind of looks like both. You are definitely ER/PR positive though, with HER2 pending. Either way it’s cancer.

take deep breaths. The waiting is the worst part, but eventually you will get a treatment plan and start moving towards a cure, and that will bring some relief to the fear and anxiety. Although the fear will remain for a long time, it does get better.

moderators

Dear wamama, we're sorry for the circumstances that have brought you here, but we're glad you've found us.

We know, you must be scared and confused as you read the pathology report, with lots of new terms and information. May we suggest that you check out the article Understanding Your Pathology Report., from our main site, where you'll learn more about important characteristics of the breast cancer and other information that will help you and your medical team choose the best treatments options.

We hope this helps! Please keep us posted on how everything is going and use this community as a resource for encouragement and support.

We're thinking of you!

The Mods