Trying to understand Pathology report

tangandchris

I'm looking at my pathology report again and I'm not understanding the "mumbo-jumbo". What I do get is that my diagnosis is Invasive Ductal Carcinoma, Histologic Grade 3(what does this mean). I am estrogen/progresterone Positive Allred score 8. (what is the allred score)Her-2 is negative and Ki-67, approximately 10% of cells. AGain...not sure what this is.

And then there is something about Staining: Right Axilla-Metastatic Carcinoma Of Breast Primary.

Can anyone help with this?

bennymuffins

I can't help you with all of it but the grade 3 refers to poorly differentiated cells and so reproduce quicker than grade 2 or 1. I've been told that grade 3 cells also respond very well to chemo. Estrogen/progesterone positive means that the cancer cells respond to your hormones, feed off them if you will. This means that you can benefit from hormone therapy which can reduce the risk of occurence. I don't completely understand Her-2 negative but I do know that Her-2 cancers respond to another drug called Herceptin. I'm sure someone will be along shortly who will know more than me but just wanted you to know that we're out here and get at least a partial answer to you right away.

SpecialK

Here is some information that may help you understand your report. Grading is done with a scale that pathologists use when examining cancer cells under the microscope. It looks like your report was generated using the Bloom-Richardson/Nottingham grading method. This grading method uses three categories, and assigns a score of 1-3 depending on what is seen. The three categories are Tubular Differentiation, which means what percentage of the cells are forming tubular structures, Nuclear Pleomorphism, which has to do with size and shape of the cells, and Mitotic Rate (Count) which has to do with speed of cell division. You take the score of each category and add them together - a score of 3-5 is grade 1, 6-7 is a grade 2, and 8-9 is grade 3. Grade 3 generally signifies a more aggressive pattern of growth.

Your Allred score is the method used for determining your hormone receptor status. Here is some info from BCO on this method. The good news is that your result was definitive and hormonal therapy would be appropriate for you - more than 2 out of 3 of breast cancers are hormone receptor positive.

An Allred score between 0 and 8. This scoring system is named for the doctor who developed it. The system looks at what percentage of cells test positive for hormone receptors, along with how well the receptors show up after staining (this is called “intensity”). This information is then combined to score the sample on a scale from 0 to 8. The higher the score, the more receptors were found and the easier they were to see in the sample.

In addition to determining your hormonal receptor status it is important to know if your tumor expresses an overabundance of Her2neu. It appears that yours does not - this is good as Her2+ breast cancer is generally more aggressive.

Here is some info on Ki67% from BCO - Ki-67: Ki-67 is a protein in cells that increases as they prepare to divide into new cells. A staining process can measure the percentage of tumor cells that are positive for Ki-67. The more positive cells there are, the more quickly they are dividing and forming new cells. In breast cancer, a result of less than 10% is considered low, 10-20% borderline, and high if more than 20%.

I am not sure about the other bit of info on staining without more specific details. Staining is one of the methods used by pathologists, but not sure if this is referring to an axilla biopsy sample or just referencing testing methods.

Moderators

tangandchris, as well as the helpful information you've received here from other members, the main Breastcancer.org's section Your Diagnosis goes through the meaning of each line found in pathology reports.

tangandchris

thanks for the info everyone