Please help me understand my pathology report-newly diagnosed
Hi all,
I was given the diagnosis last Friday (invasive ductal carcinoma - about 1 cm in size) and I meet with a surgeon on Thursday. I just received my full pathology report and I was hoping to get a better understanding of staging to guide my questions during my appointment.
Can any of you determine my stage from this information (I tried to remove any identifiable information). Thank you for your help!
Estrogen Receptor: POSITIVE (98%) Staining Intensity: STRONG >10% is Positive 1-10% is Low Positive < 1% is Negative Progesterone Receptor: NEGATIVE (0%) >= 1% is Positive < 1% is Negative Her2 by IHC: NEGATIVE (1+ staining) 0-1+ Negative 2+ Equivocal 3+ Positive Partial membrane staining in >10% of cancer cells with rare or absent circumferential staining Patients with breast cancers that are HER2 IHC 3+or IHC 2+/ISH amplified may be eligible for several therapies that disrupt HER2 signaling pathways. Invasive breast cancers that test HER2-negative (IHC 0, 1+ or 2+/ISH not-amplified) are more specifically considered HER2-negative for protein overexpression/gene amplification since non-overexpressed levels of the HER2 protein may be present in these cases. Patients with breast cancers that are HER2 IHC 1+ or IHC 2+/ISH not amplified may be eligible for a treatment that targets non-amplified/non-overexpressed levels of HER2 expression for cytotoxic drug delivery (IHC 0 results do not result in eligibility currently).
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Hi @katieat2004, I'm sorry that you have to join us here. Staging can't be done on biopsy results alone since it's just a small sample of the tumor. That only happens after the surgical pathology. The information that you were given shows that the tumor is IDC (originating in the milk ducts but affecting other tissue,) highly ER+ (many estrogen receptors,) PR- (no discernable progesterone receptors,) and HER2- (very little human epidermal growth factor.) If the size turns out to be less than 2 cm it will probably be stage 1 which is highly treatable. Your exact treatment will depend on other factors like your age and preferences but those with this diagnosis are often offered the choice between a lumpectomy with radiation or a mastectomy with/without reconstruction. Given the high ER+ you will most likely be prescribed AIs (aromatase inhibitors) or tamoxifen for 5 years to help reduce circulating estrogen levels and prevent recurrence.
You can read about the pros and cons of the two surgical procedures so that you can discuss this with your doctor. Whether or not chemo is recommended is often dependent on the Oncotype DX (or similar test) result which is done if your final pathology tumor is greater than a certain size. I hope your appointment goes well. This is a good place for information and support as you undergo treatment. All the best.
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Hi Maggie, Thank you so much for your quick response! I'm so sorry that you are here as well but it means a lot that you would take the time to reach out to me. I thought I was being so calm and cool about this and I completely fell apart last night. I want to get a plan in place and get going!
I hope you are doing well on your journey and again thank you~
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@katieat2004 …. When I first got my Pathology report in May I was just like you. It's like a huge wave of WHATS THIS and What's going to Happen. I think Maggie did a great job of explaining everything. One of my first questions was What Stage am I, we hear so much about Stage 4 Cancer and want to see how low our stage is, but other factors are important.
After my diagnosis in April of this year, I was ready for surgery, but before that, I had to conduct my genetic testing (checks for DNA mutations that might place you at a higher chance of reoccurrence) and get my Oncotype testing completed. This helped the doctors give the best guidance on what type of surgery I needed. My Genetic testing was negative for mutations and my Oncotype score was low, so I chose to have a Lumpectomy (May 30, 2024). I traveled off the island to have my surgery and to start my radiotherapy treatment next month. Thankfully because my numbers were good and the tumor was small I was given a stage 1B of Invasive Ductal Carcinoma
I was also able to get valuable information during each phase of the journey from
GO SLOW… don't jump to the next step until you have to because you'll become overwhelmed. It's best to watch a video or two to get a good foundation before your appointments so you know what clarifying questions you should ask when you meet the doctor. Oh… Today is Thursday… that means you met with your surgeon. How did that go?
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