Pathology Report Interpretion: Please help

cutiekate

I felt the lump during Christmas and was newly diagnosed with IDC stage 2 last Friday. I will see the breast surgeon for consult next week. I am 44 years old,

My lab result:

Estrogen +50% staining intensity 2+

Progesterone +23% staining intensity 2+

HER2 Equivocal Score 2+

Ki-67 Antigen: 25%

I am considering bilateral mastectomy & breast reconstruction because i have a family history of breast cancer. I will ask my doctor if my insurance will cover the charge on the healthy breast. Do I still need radiation/chemotherapy if I opt for double mastectomy?

HeartShapedBox

Your treatment will also be dependent on the size of your tumor, the extent of involvement (has it spread to lymph nodes or elsewhere), your accurate HER2 status, and your surgery choice. Because you tested as "equivocal", you will need to retest with the more expensive/accurate FISH test to determine if you're HER2 positive (which does require chemo, and Herceptin).

Radiation is needed with lumpectomy, and CAN be avoided with a mastectomy sometimes. But again, depending on tumor size, involvement, and HER2 status, radiation may be recommended. Make sure you make an appointment with a medical oncologist as well; they will be part of the team that helps determine your treatment needs.

cutiekate

Thank you so much for your response. My tumor size on the mammogram/ultrasound report is 2.4 cm. I don't know yet if it has spread, but the report said "There is a borderline right axillary node identified".

Beesie

"I will ask my doctor if my insurance will cover the charge on the healthy breast."

If you are in the U.S., then by law your insurance must pay for any symmetry surgery to your contralateral breast including a mastectomy and reconstruction, if desired.

"Do I still need radiation/chemotherapy if I opt for double mastectomy?"

Rads, possibly not, but it depends on a number of pathological factors about your diagnosis, as explained by HeartShapedBox.

Chemo, if it's recommended, will be required regardless of whatever surgery you have. Chemo is given to reduce the risk of a distant (i.e. metastatic) recurrence. That risk (the risk that some cancer cells might have moved beyond the breast into the body) is based on the aggressiveness and pathology of the cancer and is not reduced by having a mastectomy.