Invasive Mammary Carcinoma

ProudSchnauzerMom

My question: Is the initial biopsy really an indicator for staging? Is the clinical stage close to the surgery stage? Trying to prepare for what's to come.

Some background, I'm 43 years old and recently diagnosed from a biopsy in my right breast with invasive mammary carcinoma with lobular features (80%). There's a bunch of stuff in the report I don't understand, it shows low combined Histologic grade, low proliferative rate and 3mm in greatest linear extent, involving 4 of 11 cores. ER/PR positive HER2 Negitive.

Surgery is scheduled on August 28th for a double mastectomy (skin/nipple sparing). Tomorrow, I go for an MRI and TERRIFIED. Always fearing the unknown. I suspect that the MRI will show a clearer picture that I may not be able to stomach. Then… there is the surgery with the real diagnosis of staging.

Moderators

Hi ProudSchnauzerMom-

We want to welcome you to BCO, and tell you how very sorry we are that you've joined us here. We know these first days and weeks are full of uncertainty and fear, but just take it a day at a time.

If you'd like, you can post some of your pathology report here, our members are very well-versed in deciphering some of the medical jargon and things you might not understand.

We know it's scary and hard not to freak out, but like we said, take it a day at a time and one appointment at a time! We're all here for you, and we'll help you through this. Please keep us posted on your MRI and results!

The Mods

ProudSchnauzerMom

Thank you! I'm freaked out. What are cores and how does that impact stage? Also, I keep reading size matters in staging. Is the report saying that 3mm are invasive carcinoma and spread to fibrous stroma?

My pathology report:

DIAGNOSIS:: Breast right, central inferior, stereotactic core needle biopsy: Invasive mammary carcinoma with lobular features (80 %):Low combined histologic grade, low proliferative rate; at least 3mm in greatest linear extent, involving 4 of 11 cores; microcalcifications present in association with invasive carcinoma and fibrous stroma; focal atypical lobular hyperplasia (see comments)

COMMENTS: Multiple level sections were examined on blockes 1a-1c

IMMUNOHISTOCHEMICAL RECEPTOR::

Estrogen receptor: strong expression in approximately 100% of neoplastic nuclei

Progesterone receptor: moderate expression in approximately 80% of neoplastic nuclei

HER2 FISH RESULT: NOT AMPLIFIED
HER2/cep 17 ratio = 1.0

GROSS DESCRIPTION: (more to this part) 11 cores of yellow-white and pink fibrofatty tissue measure 1-3 cm in length and 0.1-0.4 cm in diameter.

Georgia1

Hi there. I'm not a doctor of course, but my read of your report is that it's not that bad. Three millimeters is tiny. Low histologic grade and low proliferation rate are good findings. ER and PR+ means that anti-estrogen therapy (pills after surgery) will works very well.

I don't think the number of "cores" really indicates much of anything.

Breathe. Hang in there. We are here for you and if you need more info try posting this in "Interpreting Your Report" which is DJMammo's thread. He's the best.

Have you discussed lumpectomy vs masectomy with your surgeon?

beach2beach

Hi,

Just to add on I believe cores is the amount of samples they are looking at. So 3 invasive and the rest all good. 3mm is tiny. If it it helps, mine was 7mm on biopsy and after surgery it still was 7mm . Yes size plays a part in staging but it can be a larger tumor and not be very aggressive and a small one could be. Make sense? So by biopsy it seems yours shows small, with all you have so far sounds like stage 1. All great news, including being so ER+ and PR+ too. Final is pathology after surgery. Only thing that changed on mine was initially they told be IDC but it wound up being ILC after surgery. I chose also to do a double, nipple sparing mastectomy.

You'll have more people chiming in soon and if you post under the interpreting your report forum, you will get feedback there also. Here is the link..hope it works... https://community.breastcancer.org/forum/83/topics/858196