Decipher pathology report

chubabubba

Can someone decipher my pathology report? It says the final diagnosis is invasive well differentiated ductal carcinoma.

The Nottingham score is 4 (invasive ductal cancinoma with well developed tubules (1 point), moderate nuclear pleomorphism (2 points) low mitotic rate (1 point). The largest contiguous focus of tumor is 5 mm. There is associated low grade DCIS, solid pattern.

ER positive, 99% of cells stain with strong intensity; PR positive, 20% of cells stain with weak intensity. The HER2 is apparently on another report since it wasn't included.

Chubby

LisaAlissa

Could you tell us a bit more about where you are? You are "just diagnosed" based on where this thread is...so is this from a biopsy? You're now at the stage where you'll be planning how to treat this. Lumpectomy with rads? Pre-surgery chemo or hormonal treatment (adjuvent therapy)? There are many, many other options & paths...and you may well want additional testing (perhaps oncotype? MRI?) to help you make decisions about some of this.

Some of the docs you may want to see now include a breast surgeon/surgical oncologist, radiation oncologist, and a medical oncologist. How you put together that team will vary depending on where you are/who your current docs are. What docs have you seen so far? One of those will be the best person to explain the fine details of your particular biopsy.

There is undoubtedly more to be said, but:

You have both IDC and DCIS. In planning treatment they'll (usually) ignore the DCIS and direct treatment to the IDC. The treatment for the IDC will deal with the DCIS.

The hormone receptor positive character means that you'll be able to use hormone treatments. (That's good!)

5mm is very small. Also good!

Please let us know how you are.

LisaAlissa

chubabubba

Thanks for the information. I had a biopsy last week and this is the report from that. I'm meeting with a doctor on Friday. The hospital has a team to work with each patient and I've been impressed with everyone so far. An MRI seems to be standard with this group and I'm sure that will be scheduled soon.

windingshores

Well, if you have to have cancer....this is Grade 1, small, "well differentiated," and ER positive- all good.

Are you having a lumpectomy? If so, you will do radiation followed by hormonal treatment most likely.

The real answers come after the surgery, with the pathology then showing whether lymph nodes were involved.

Once you have the HER2 results you will have an important piece. You can have it done on the post-surgical specimens.

If negative, then you should ask for an Oncotype Dx test, or your MD will just order it. That will help you decide about chemo, but it seems like you have a good chance of not doing chemo from your results so far.