Can you help me make sense of pathology report? I am confused!

DanielleDoodle

I am waiting to get a 2nd opinion, but i think my whole pathology doesn't make sense. Like having such a large tumor but no vascular or lymph invasion etc. I know you are not Dr's but wanted some opinions til my appt for follow up. 2 different Dr's that looked at it said it was odd and didn't make alot of sense, and thought it should be looked at to see if there is some benign features that resemble BC.

Extent of Invasion: pT4b Ulceration of skin-Margins: Margins involved by invasive carcinoma. Specify Margin: Deep Extent of involvement: FocalVascular/lymphatic invasion: Not identified--Regional lymph nodes: No regional lymph nodes metastasis Total examined:12

Pathological Staging: pT4b pNO

Breast left simple mastectomy. Ulcerated and Fungating IDC, 13.5 cm in greatest dimension with invasion into the deep skeletal muscle focally extending to the deep inked margin of resection.

Left simple mastectomy with axillary dissection

Historical grade: 3

Microscopic and macroscopic extent of tumor: Carcinoma invades skin with ulceration and also invades pectoralis muscle.

Tumor Focality: Single

Size of Invasive Carcinoma: 13.5 x 10 x 6.4 cm

Ductal carcinoma in situ: Not identified

Er-0%

PgR-0%

Ki67-95%

Results: HER2/neu non-amplified with HER2/CEP17 ratio 1.8 and mean HER2 signal 3.5.Although not equivocal, the HER2 FISH result is borderline. An additional paraffin block from this large mass could be sent for repeat studies if clinically indicated.

NancyHB

Danielle, I don't have much to offer specifically. What is your next step at this point? A second opinion certainly sounds in order, hopefully you’ll get more answers.

There's another member here with what sounds like the exact same diagnosis, perhaps you can connect with her and she can offer more insight and support. Her screen name is barrthorp.

Ihavebreastcancer

DanielleDoodle, the good part is that there was no lymph node involvement on the left axillary lymph node dissection out of 12 lymph nodes removed, but there can sometimes be involvement in other regions like internal mammary, or infraclavicular regions. You should get some radiological testing like ultrasound to evaluate this other regions.

Also it is very important to review this report with your surgeon because you do not have clear margins with the surgery, the tumor is invading the skin and pectoralis muscle, so your surgeon needs to consider reintervention to remove the involved muscle. You had a simple left sided mastectomy, there are other surgical options which involve removal of the pectoralis muscle.

Also very important is your receptor status, ER/PR negative with the HER status for now equivocal, looks positive, but it looks that they are doing more testing. You need to discuss with your medical oncologist regarding options of treatment based on receptor status after HER status will be established.

Your tumor is IDC/infiltrating ductal carcinoma high grade3, and high ki67. Likely stage 3B, given that you have T4N0M-unknown, you likely need more testing to evaluate if other parts of your body are involved, this tumors unfortunately could have distant metastasis on presentation. This is a relatively rare tumor called ulcerative and fungating because is growing under the skin and breaks through the skin

Kakao

Hello!

My mother has invasive carcinoma GRADE 3,

pTNM classification:pT2 multi , pN3a, pMx, pR0, pLV1.

ER/PR- ; HER3+; ki-67-25%

what stage?, what is the hope of survival in one year, three year

Moderators

Hi Danielle and Kakao, welcome to Breastcancer.org! Sorry you have to be here, but glad you've found us!

Perhaps the following article from our main site could be of help: Your Breast Cancer Diagnosis. In this section you can read more about what the pathology report is likely to include and what all that information means.

Hope this helps! Please, let us know how you're doing!

The Mods