Help with Pathlogy Report...Good or Bad

jkz

Hi Everyone,

I just received my final report. I had a bilateral last Tuesday and am sort of clueless to the results and my surgeon is in Chicago til Monday. I have an appt scheduled Monday am but would like some feedback on these results.

ER - 78% Favorable /  PR 89% Favorable / HER2/neu 1+ Not Over-Expressed / Ki-67 44% Unfavorable

What does all this mean? Chemo? No Chemo? Meds no meds.  Is there anything else that I should be looking for on these reports? I know I had DCIS w/ some IDC. Looking forward to any and all responses. thanks Jennifer

dsj

I think the ER and PR positive is good news.  Don't know about the Ki-67.  Did you have a sentinel node biopsy?  The results should be on the pathology report.  Also the grade and size. 

 If you have DCIS and IDC, they treat in terms of the IDC.  You should post this on the IDC board, since if there is chemo it will be for the IDC not the DCIS.  That is, the people on the IDC board will probably have more specific suggestions/responses.  Good luck with talking to the doctor on Monday: waiting is absolutely the worst part I think.   

IronJawedBCAngel

Because of your hormone positive status, your cancer should respond well to hormone therapies such at tamoxifen or an AI like Arimidex, so that is good.  Not having Her2 gene overexpression is also good.  The ki-67 is a measurement of a nuclear protein that indicates the tumor cells tend to be more active, so while I am not a doctor, I would think that it increases the odds of chemo.  God bless you, I know this is a very stressful time and waiting to talk to doctors is difficult.  If you have a cancer resource center nearby you, you can take your pathology report to them and they will go over it with you and explain anything you do not understand.

laurakay

Maybe I shouldn't get involved here too much, being pretty in the dark myself.  But did they check your lymph nodes?  My (vague) understanding is that chemo will only help this situation if the cancer has spread, and that they would tell this from the lymph nodes?  If you did not have spread, and you've had both breasts removed, there would be no reason for radiation.  And if it hasn't spread, why would they do chemo?

Again, to say I'm no doctor is an understatement, but I have just gone through all this myself, had all these questions before my path report, and these were the answers I was given.   

I'm so sorry this is Friday-Monday.  But hopefully you can get some information to put your mind at ease between now and then. 

jkz

Yes my lymphnodes are clear. There was some IDC though..

IronJawedBCAngel

Stray cancer cells can also move through your bloodstream without appearing in your lymph system so they do consider chemo sometimes even when nodes are not involved.  Radiation after mastectomies depends on how far from the chest wall the cancer cells were.  If the margins are not all that large, sometimes radiation is recommended after mastectomies.  The ki-67 indicator is what would be the unknown question in the pathology, as it is high enough to be listed as unfavorable.  Every oncologist is different and you truly won't know what your treatment plan is until you have your appointment.  You could also post a question on ask the expert at John Hopkins as I have found them to be a great source of educated information.  I have utilized them in the past as another opinion when trying to make a treatment decision.