Biopsy pathology vs. Post-surgery pathology

berries

I'm wondering if people had vastly different results in their pathology of their biopsy vs. what came back after surgery?

Was the grade, stage, etc. changed at all for you? Just wondering the accuracy of the biopsy and if I should expect a vastly different outcome after surgery or if it should be somewhat similar?

Love to you all.

x

Tmh0921

the only surprise I really had during final pathology from initial biopsy was the size of the tumor, and the fact that I not only had IDC, but DCIS as well, but this is pretty common.

My mammogram had my tumor sized at 1.1cm, my Breast MRI had it sized at 1.9cm, and the final pathology had it sized at 3.2cm. They really can’t officially stage you until the final pathology is in

Tracy

berries

My initial pathology also shows DCIS, but was diagnosed with IDC.

Other than size, did anything else change for anyone?

Thank you!!

ItsHandled444

DCIS was diagnosed with biopsy, IDC was also diagnosed with lumpectomy pathology.

Hugs!

gretchy

I'm wondering the same thing. I wad diagnosed with LOBULAR CARCINOMA in situ but with microinvasion. The oncologist said she won't know the extent of the microinvasion until after the pathology reports from the surgery.

edj3

Yes, there were differences between the path reports for the biopsy and the lumpectomy AND the MammoPrint test (which used tissue remaining from the lumpectomy).

Biopsy report indicated DCIS and IDC. Lumpectomy report agreed and also found LCIS. MammoPrint added in lymphovascular invasion as present (other two said negative). My Bloom's score was a 6 on the biopsy and a 7 on the lumpectomy.

My MO said it's pretty subjective and also depends on the slice of tissue being examined. So in my head I just go ahead and acknowledge IDC, DCIS, LCIS, some sort of lymphovascular invasion and a Bloom's score of 7. Better to keep the slightly worse view in mind, even though mine's far from the worst.

TB90

It can and often does change following surgical pathology. My Breast Surgeon would not even discuss diagnosis until after surgery. The longest wait of my life. All the best

mom2bunky

Yes mine changed, I was downgraded from a 2 to a 1 and the tumor was slightly smaller than they thought.

HopeWins

vmb I think I've read that dx is stepped up a notch about 20% of the time. It happened to me. Stereotactic biopsy showed ADH and some other benign but red flag type cells. Excisional biopsy showed DCIS. They thought they got it all but I had a close margin. I chose a bmx and final path showed additional DCIS. Not a lot, but more where they thought there was no more. So size changed as well as the dx at each step of my journey. It does feel like a moving target but the lumpectomy pathology is a very good indicator of what you're dealing with.

Based on everything I've seen, I think the scans are good but miss a good portion of cancers. They're the best we have, but only so good. The stereotactic biopsy was mammogram assisted and it simply missed the cancer. The excisional biopsy/lumpectomy allows the surgeon to use their eyes to excise the mass. Even the naked eye isn't perfect. My BS told my husband she saw nothing of concern after surgery, so my dx was a shock.

Best of luck to you!

berries

Thank you all for your kindness! I'm SO sorry you have to go through this.

I will be getting a left mastectomy with immediate reconstruction. My fear/concern is that while I'm stage II, after surgery what if what they thought/tested/confirmed all along is WAY OFF? I can't sleep at night thinking that my post-sure pathology is going to be so, so wrong from what I know now.

2019whatayear

my biopsy said IDC grade 2 size 1.7 , nothing in lymph node biopsied stage 1A

after surgery pathology ICD grade 3 (Nottingham scale score 8- but I guess that doesn't really matter that much) size 2.2 x 2.0 x1.9 micromet in sentinel node .8mm new state 2b.

I was really chapped about the previously biopsied node coming back with some cancer. That sucked I asked my BS so what's the deal. Did the cancer slide on over to the node btwn the biospy and my surgery ( was 53 days). She was like not likely, more like the core sampled missed the cancer. So since node had a little she did auxi. dissection - her philosophy if there is 1 cancer cell in the sentinel node I'm taking a slice. all the other nodes were clear.

So what I'm saying its you probably will find that you don't have any thing in any nodes. But hard as it is --it helps nothing to stress about it. So do your best to do some fun things as you wait- as much as you can.

B-A-P

my biopsy said I was 100% Er + Pr- and her2 -

After surgery I was 100+ Er and 50% Pr+. Still her2-

letsgogolf

My biopsy report said IDC, grade 1. Lumpectomy report said IDC with Lobular features, still grade 1. Ultrasound measurement of tumor was exactly right. Was surprised with 1 node having a micromets but I read that is very commom with IDC/L for some reason that nobody really understands.

Rah2464

Mine went all over the place. MRI imaging had potential mass at 1.7mm, US (now that they knew where it was due to MRI) showed around 2.5mm. Core biopsy indicated DCIS. So headed into surgery with BS telling me I could be a stage 1 or 2.

Final pathology was 1.3mm mass with IDC and DCIS, stage 1. Apparently it is very common for imaging to mask the actual size of the tumor if you have dense tissue. So I was all over the place until I got my final report. But it was a relief to finally know that it was out and I could move forward with a treatment plan.