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Help Interpreting Preliminary Pathology

waitingaway Member Posts: 17
edited February 9 in Just Diagnosed


I was diagnosed with breast cancer this week. I just saw my preliminary pathology reports uploaded to my health portal; is anyone able to help me understand what it means?

  1. Invasive carcinoma of no special type
  2. Preliminary Nottingham grade 3; tubular score = 3, nuclear score = 2, mitotic score = 3
  3. Carcinoma involves 2 of 3 cores, maximum linear length of 5mm

What is the significance of the tubular score? What is the significance of the maximum linear length?

I”m still navigating what shows in my signature/updating it - this has happened quickly.

Discovered lump mid December

Ultrasound & Mammogram late January.

Core needle biopsy last week.

Cancer diagnosis on Monday.

Getting additional pathology results tomorrow and meeting with a surgeon on Tuesday.

I’m only 38. I have a 3 year old. No family history of breast cancer on either side. I don’t understand what is happening to me…


  • flowergirl1975
    flowergirl1975 Member Posts: 57

    Hi @waitingaway ! I’m so sorry you are having to go through this…. Breast cancer sucks. I think a lot of us have wondered the same thing, why this is happening to us. I know I have. The best person to explain your path report is an oncologist and/or surgeon. I know it’s hard to wait but they will have all the answers you need. The Nottingham histologic score (or histologic grade) is a scoring system to assess the "grade" of breast cancers. The grade is a way to rate how aggressive a tumor may behave.The beginning of this journey sucks and is an emotional roller coaster. Once you meet with the doctors and have a plan of action things will start to get better. It’s going to be a long rough road but you can do it! There is light at the end of the tunnel. You are strong and can get through this! Hang in there! Hugs!

  • kaynotrealname
    kaynotrealname Member Posts: 417

    First of all, I'm so sorry. We all have this sort of out of body experience when first diagnosed. It's devastating and you wonder if you'll ever be happy again. Know that this is the worst time, the information gathering time as I call it, and once everything is known and you start treatment, joy can return in abundance. In saying that, you don't have a lot of information yet. At some point soon you should get your receptor results which let you know if your tumor is feeding off of any hormones and also an estimated size. But what you do have is the grade which is 3. That is the highest grade and the most aggressive and although not ideal it's also not uncommon especially in younger women. I had a grade 3 for instance. How they determine the grade is through the measurement of three of your tumor characteristics, tubular score (1 -3 and it measures how much of your breast looks like normal tissue, 1 being the most and 3 being the least) nuclear score (1 - 3 and it measures how large the nucleus is with 1 being little variation in size and shape and 3 being the most) and then mitotic score (1 -3 and measures how fast the cells divide with 1 being the slowest rate and 3 being the quickest). You also have the type of IDC mentioned which is of no special type. That's the most common. And then lastly they took 3 samples of your tumor's area and 2 out of 3 came out with cancer, the largest specimen being 5mm. If you have any other questions after getting more information just let us know. You are not alone in this and have an army of women who will be glad to help you anyway we can. Many hugs sent your way.

  • exbrnxgrl
    exbrnxgrl Member Posts: 4,959


    I’m sorry you find yourself here. Although we can comment on your report findings and via our experiences with bc we may be able to interpret some of it and be correct, we are not doctors. Yes, the waiting is awful but it is important that when you have your appointment that you are very clear headed with no pre-conceived notions from non-medical professionals. It is your doctor’s interpretation that counts and will drive treatment decisions. Take care

    • The vast majority of those dx’ed with bc have no familial genetic connection.

  • moderators
    moderators Posts: 8,216

    Hi @waitingaway,

    First, we're so very sorry to hear of your diagnosis. We know the beginning is very overwhelming, but the more information you find out about what you're dealing with, and get a treatment plan in place, the better you'll start to feel. Knowledge is power and we're all here for you!

    Our section on Understanding Your Pathology Report will help you walk through what each piece of information means as it comes in, including Nottingham Grade, Size of the Breast Cancer, and Invasive vs. Non-Invasive Breast Cancer, and much more. In addition, you can learn more about Invasive Ductal Carcinoma.

    We hope this helps. Please let us know what other questions you have and how we can support you. You've got this!

    —The Mods

  • waitingaway
    waitingaway Member Posts: 17

    update as of Feb 13 - got the rest of my pathology results and saw a general surgeon, confirmed triple negative, stage 3 // T3, L1, M?. Scheduled for a CT and MRI next week, butBC Cancer is “overloaded” so it will be a couple weeks before I can have an initial consult with an oncologist. I am having an axillary lymph node biopsied (is it excisional?) but no idea when. I feel like the clock is ticking to get treating this as it’s grown so much since December and now lymph nodes are involved, and am discouraged - was 2.5 cm at its widest, now it’s over 5.