Pathology report - better, worse or as expected?

clars,

I completely understand your fear but am wondering how any of our experiences might pertain to you. Despite many commonalities breast cancer , through almost every step of dealing with it, can be remarkably different for each person. Yes, surgical pathology reports can differ from biopsy reports but then again, they might not. This site is also very biased in that those who have surprises and issues along the way tend to post whereas those who don’t, stop posting.

Will answering these questions comfort you or further stress you out? The only thing I can say with certainty is that none of our experiences is predictive of what yours might be. Knowing this, here are my answers which, again, have no predictive value to you. Take care and try to deal with what you know for certain today and not speculate on what you don’t yet know. This isn’t easy to do, but worth cultivating.

• One positive sentinel node that was not previously noted
• I wasn’t expecting anything as I knew the surgical pathology report would be the final word. I have no medical training or expertise so I simply waited until the path report revealed its findings.
• Grade remained the same, grade 1
• 6 weeks after surgery, on an unrelated PET, a bone met was discovered. Biopsy showed it was a twin to my breast tumor and still grade 1. No one else’s experiences could have predicted or prepared me for this, nor should anyone take my experience and think that the same is going to happen to them. Crazy good luck has me approaching 12 years without progression which unfortunately* means nothing in terms of what others might experience.

*I say unfortunately because their is no explanation for my survival thus I have nothing positive to share about why I have been so lucky.

Scanning can't catch everything. A biopsy is way more accurate that every expensive scanning up to date. In my case, even with all the fancy scanners in a well-known hospital, before surgery, I was told of 3 active areas in one breast and negative nodes. I was so terrified that I asked for BMX. I am so glad I did because cancer was found in both breasts and 2 out of 5 nodes were positive. How I see it is before surgery scanning is the first draft and after surgery, pathology is the final version. Lots of changes are in between. Prepare for the worst and hope for the best.

I think maggie15 hit the nail on the head when she mentioned certainty. We all want it in life, particularly in response to a serious disease. Clars, I wish there were some way to find certainty with a bc dx or some way to predict where you might end up based on the experiences of others but there simply isn’t. Go with what you know today, and work hard to not go down paths that might never apply to you.

exbrnxgrl is completely right in her response. Nothing any of us say remotely affects what will happen with you. That being said, pathology reports differing from the biopsy happens frequently. I was told though that at least with what they were seeing with me they weren't expecting significant changes and they were right. My hormone, lymph node, grade, and LVI status remained exactly the same. What differed significantly for me was the size. The knew the total area of concern was around 36mm but thought most of that would be DCIS with about a 18mm IDC. It ended up being a 32mm IDC with no DCIS found. Since nothing else differed though, my treatment remained exactly the same as what they thought before surgery which I was told depended on the oncotype score. I didn't like going from stage 1A to 2A (or 1B based on the prognosis staging system) but breast cancer is tricky. Anyway size changes upon final pathology report is more common with women who are younger because scans are tricky to read when you have dense breasts. Either way the treatments for breast cancer are plentiful and quite good. They'll be able to handle whatever your pathology report throws at them but hopefully you won't see significant changes. For most people, some things may differ but not enough to affect treatment.